Surgery for Adolescent Idiopathic Scoliosis

The treatment chosen for idiopathic adolescent scoliosis will very much depend on the severity of the curve and how far along the child is in skeletal maturity. Surgery is often recommended for adolescents whose curves are greater than 45 degrees while they are still growing or whose scoliosis is greater than 50 degrees after their growth has stopped. Corrective surgery is usually necessary for rapidly growing teens or larger curves.

When surgery is necessary for scoliosis, the experts of Weill Cornell Medicine Neurological Surgery take the least invasive approach possible. The goals of surgery are to straighten the curve, halt its progression, and stabilize the spinal curve, typically with instrumentation, while accounting for overall spinal balance. The surgeon will choose specific surgical procedures for the patient depending on the details of the diagnosis. Our spine surgeons have developed expertise in some of the most technically advanced surgery for scoliosis in adolescents.

The surgeon may approach the spine from the front, back, or a combination of both. The choice of technique depends upon the age of the individual and how mature the skeleton is, the flexibility of the spine, the location and degree of the curve, and whether there is any nerve-root compression.

Minimally invasive spinal fusion surgery fuses the bones of the spine in the affected area together so that there is no longer any motion between them. This means the vertebrae in the curved areas will be fused together to make one long bone. It will be straightened with the use of rods and wires attached to the bones. This reduces spinal pressure, pain, and nerve damage and fixes the deformity. Minimally invasive spinal fusions do not require the large incision or the muscle retraction typically used in conventional fusions. Patients undergoing this procedure have a fast recovery time. A recent advance is the use of a computerized image guidance system for many patients undergoing spinal fusion. This has the advantage of aiding the surgeon in optimal placement of screws and avoiding injury to delicate nerve tissue.