Scoliosis Surgery for Children: What Parents Should Know

There is more than one way to respond to a diagnosis of scoliosis: with or without surgery. While treatment results can never be guaranteed, a child's spine can be highly responsive because it's constantly growing, making it more flexible. Particularly when diagnosed early and treated proactively, there are fewer limits to what non surgical treatment can achieve.

What parents should know about scoliosis surgery for children is that it's not always necessary, particularly with early detection and intervention. Spinal fusion surgery is invasive and comes with some serious potential risks, side effects, and complications.

Spinal fusion surgery is not always necessary, and modern conservative non surgical treatment provides an effective alternative.

What is Scoliosis Surgery?

There are different types of scoliosis surgery performed but the goal is consistent: stop the scoliosis from getting worse.

What I want parents and/or caregivers to understand is that stopping scoliosis from progressing, while important, isn't the same as having the goal of correcting scoliosis.

Correcting scoliosis means addressing its underlying structural nature, but spinal fusion surgery and traditional treatment have a different approach.

Scoliosis causes the spine to bend and twist unnaturally, and as a progressive condition, its nature is to get worse over time, and this means the size of the unnatural spinal curve will increase, as will the condition's effects.

Spinal fusion surgery involves identifying the most unnaturally-tilted vertebral bodies of the curve and fusing them into one solid bone, and this commonly involves the removal of intervertebral discs that sit between adjacent vertebrae to be fused.

Metal rods are attached to the spine with pedicle screws to maintain its position.

Potential Effects of Scoliosis Surgery

While scoliosis surgery was the dominant treatment choice for many years, that doesn't mean it's the best or only treatment option available, and as the procedure comes with some serious potential risks, side effects, and complications, it should be considered carefully.

Scoliosis surgery can straighten a bent spine, when successful, but results can never be guaranteed, and every patient will respond to spinal fusion in their own way.

While some patients who undergo spinal fusion maintain enough flexibility above and below the fusion site, many are disappointed with the loss of spinal flexibility and range of motion they are left with; for young athletes, this can disrupt quality of life and cause activity restrictions.

A spine that's fused is one that will be more rigid and less moveable, and in addition, a fused spine is going to be weaker and more vulnerable to injury.

When it comes to treating childhood scoliosis with surgery, there are also different types of spine surgeries to consider that approach the challenge of growth differently.

Scoliosis doesn't become a compressive condition until skeletal maturity has been reached, which is when the spine has stopped growing and it, and its surroundings, become vulnerable to compression and pain as a result.

When growth is still occurring, and significant growth spurts and rapid progression are predicted, there is another type of spinal fusion that can be offered to children: vertebral body tethering.

Vertebral Body Tethering

Vertebral body tethering (VBT) accounts for growth a young patient has yet to go through and is a more minimally invasive procedure than traditional spinal fusion using metal rods.

Also known as anterior scoliosis correction, vertebral body tethering uses fibers attached to certain vertebrae with pedicle screws, and tension on the spine is adjusted via the fibers; tension can be adjusted based on the changing needs of a growing spine.

While traditional spinal fusion involves cutting through muscle to access the vertebrae, VBT accesses the spine through small incisions cut down one side of the patient's body, and it's through these portals that muscles can be pushed aside, rather than cut.

Each patient's recovery period will be unique, but the more muscle cutting that occurs, the longer the recovery is likely to be.

A small camera and scope are passed through the small portals for precise visualization of the spine so screws to attach the tethers to can be precisely placed, and the tension of the tethers can be adjusted accordingly based on how the spine is responding to growth and/or treatment.

This approach is known to preserve muscle strength and health, along with spinal function.

Another surgical approach to scoliosis surgery in children involves the use of magnetic growing rods.

Magnetic Growing Rods

Magnetic growing rods are also considered less invasive than traditional metal rods as they can be lengthened according to growth through the use of an external magnetic control device, limiting the likelihood of revision surgery.

This type of approach can be beneficial because in traditional spinal fusion surgery using metal rods, if the procedure fails for any reason, including hardware malfunction, the only recourse is more surgery.

Magnetic growing rods allow for the length of the rods to be adjusted without the need for more surgery and are typically used in cases of early onset scoliosis in need of severe scoliosis correction.

When spinal fusion is performed on children to stop curve progression, the younger a child is at the time for the procedure, the longer the hardware used has to last, and a fused spine is fused for life.

There are, however, scoliosis specialists who focus on the corrective power of non surgical scoliosis treatment, and the reality is that not all cases of childhood scoliosis need surgery.

Non Surgical Scoliosis Treatment

What I really want parents and caregivers to fully understand is that a scoliosis diagnosis doesn't have to mean future invasive spinal surgery.

Particularly with early detection and intervention, there are fewer limits to what can be achieved with non surgical treatment.

When it comes to treating scoliosis without surgery, we're talking about modern conservative chiropractic-centered treatment, and this is what patients of the Scoliosis Reduction Center® benefit from.

A child's surgeon will have the patient's best interests at heart, but a fused spine is just not going to be as strong or functional as one that's corrected through addressing the condition's underlying structural nature.

Non surgical scoliosis treatment works to impact the condition on every level, but structural progressive scoliosis needs to be primarily impacted on a structural level.

Reducing the Curve

A non surgical response is more aligned with the spine's natural movement-based design, and through the application of Chiropractic BioPhysics® (CBP), curve correction is worked towards by manually adjusting the position of the curve's most-tilted vertebrae.

CBP is the union of chiropractic care and science, and few general chiropractors can offer the same types of structural results that a CBP-certified scoliosis-specific chiropractor can.

Muscular Support

Conservative treatment doesn't focus solely on the spine, as traditional surgical treatment does; it wants to address the abnormality with the spine, but also the condition's effects.

Scoliosis doesn't just cause the spine to bend and twist. The condition introduces a lot of uneven forces to the spine, its surrounding muscles and nerves, and the entire body.

The more supported and stable a spine is, the less vulnerable it is to a number of spinal conditions/issues.

While there is no way to prevent the development of idiopathic scoliosis in children, we know a spine that's surrounded by strong balanced muscles is one that's better able to maintain its natural and healthy curves and alignment.

A focus of non surgical scoliosis treatment is to apply physical therapy and scoliosis-specific exercises to help improve the balance and strength of the spine's surrounding muscles and improve posture.

Deformity Correction with Bracing

When it comes to spinal deformity correction in children, as their spines are still growing, they can be highly responsive to the power of a corrective scoliosis brace.

A scoliosis brace is an orthotic device worn around the torso with the goal of pushing the spine into a proper alignment; this can complement other forms of corrective treatment as they work together to impact conditions on every level.

Rehabilitation

Rehabilitation is about further healing and stabilizing the spine to hold treatment results.

As progressive scoliosis is an ongoing condition, treatment also has to be ongoing, and this can involve continued chiropractic care and the prescription of custom-designed exercises.

This phase of treatment is about empowering the patient; teaching postural awareness and remodeling through the continuation of scoliosis-specific exercises that can easily be performed from home can help sustain treatment results for the long-term.

Conclusion

As a progressive condition triggered by growth, children with scoliosis need to be taken seriously and treated proactively.

A child's age is important because it indicates the level and rate of growth still remaining, and childhood scoliosis is diagnosed through a physical examination and X-ray results.

Some children's scoliosis journey starts with successful school screening identifying condition indicators that warrant the need for further testing and lead to a diagnosis, but not all schools across the United States conduct mandatory scoliosis screening, so it's important for parents to also know the condition's subtle early signs to look for.

Many children with scoliosis present with uneven shoulders, shoulder blades, a rib cage arch, and uneven hips as the condition's earliest signs.

With children, careful monitoring is needed to observe how the spine is responding to growth and treatment so treatment disciplines can be apportioned accordingly.

Scoliosis can affect children of all ages from babies born with congenital scoliosis to early onset infantile scoliosis, juvenile scoliosis, and the condition's most-prevalent type overall: adolescent idiopathic scoliosis diagnosed between the ages of 10 and reaching skeletal maturity.

Most children can respond well to non surgical treatment, particularly with early detection and intervention, but there are never treatment guarantees.

We do know, however, that spinal surgery is invasive, and we also know that many children are disappointed with the cosmetic limitations of spinal fusion, as well as the procedure's effect on long-term spinal health and function.