When required, surgery is an important and often life changing procedure.
Surgery is usually recommended when a scoliotic curve rapidly progresses to a point where it unbalances the spine.
Surgery is not recommended on the degree of curve alone, there are other important factors to consider such as, the patients age, the balance of the spine, the potential growth and many other factors.
As a guide surgery can be indicted for some curves as low as 40 degrees, but in some cases curve of up to 60 degrees may not require surgery.
In adults surgery is usually indicated where a degenerative instability is present and there has been significant progression in a curve. Surgery in adults may not lead to pain relief and as such if pain from a scoliosis is the main concern surgery may not be recommended. Compared to surgery in children it is much more difficult to make correction in the spine of an adult.
There are various different types of surgery depending on the type and location of the scoliosis. The most commonly performed is a posterior approach fusion using pedicle screws and rods. It should be remembered that serious complication from scoliosis such as heart and lung compromise are rare and mostly associated with neuromuscular scoliosis cases. Often the decision to undergo surgery is based on a cosmetic reason i.e. because the patient does not like the way the back, ribs or shoulder look because of the scoliosis. If conservative treatment is undertake early it is often possible to avoid surgery for cosmetic reasons.