Although surgery is never the preferred treatment, in some cases it is the best and only treatment. For some patients it can be a lifesaver and they can continue to do all their daily activities and most sports and exercise forms in adult life, while for others the outcome can be less than expected and they may wish they had never had it done.
In childhood scoliosis bracing, the goal of treatment is to try and ensure the Cobb angle is under 50° by the end of growth. Depending on the age of onset and the progressive nature of the individual scoliosis this is not always possible.
Larger curves are more likely to progress in adulthood, however it is not until curves reach 90°that heart and lung function is compromised.
When scoliosis starts in infants or juvenile’s, curves can be very progressive and multiple surgeries can be required. In these cases bracing is sometimes possible, bracing can be used to reduce the number of surgeries that will be required by the time growth ends. This can mean that only one or two surgeries can be performed at the end of growth rather than multiple surgeries throughout growth. However, this must always be done under the guidance of a spinal surgeon who specialises in scoliosis.
In children, growing rods are often used to ensure that the growth of the thorax is not stunted in comparison to the limbs. Multiple surgeries are required to adjust rods so the torso lengthens as the body grows.
In adults surgery may be required to improve the cosmetic appearance or reduce pain and symptoms that are resulting from progressive spinal degeneration postural imbalance. This may occur in cases where conservative treatment methods have not helped. To ensure good surgical outcomes, surgeons must determine the extent to which pain & symptoms are caused by localised spinal degeneration compared to the worsening of the postural and spinal deformity.
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