Does My Child Need Scoliosis Surgery? What Parents Should Know

One of the first questions you may have after learning that your child has scoliosis is, "Does my child need scoliosis surgery?" Making decisions regarding your child's health as a parent can be extremely difficult, particularly if the condition affects the spine. This blog seeks to give you reassurance, professional insights, and clear instructions so you can make wise choices. Let's examine the definition of scoliosis, its symptoms, available treatments, and the circumstances in which surgery may be required.

What is scoliosis surgery?

Correcting the spine's abnormal curvature and halting its progression are the goals of scoliosis surgery. The main objective is to safely straighten the spine, enhance hip and shoulder alignment, and in certain situations, relieve pain or deal with problems like impaired lung function.

What Is Scoliosis Disease In Children?

The condition known as scoliosis causes the spine to bend sideways, frequently taking the form of a "S" or "C." Adolescent idiopathic scoliosis (AIS) is a condition that can affect people of any age, but it usually appears during the growth spurt that precedes puberty, usually between the ages of 10 and 18. "Idiopathic" refers to the great majority of diagnoses where the cause is unknown.

X-rays are used to determine the Cobb angle, which is used to quantify the degree of scoliosis. Generally speaking, curves that are less than 10 degrees are not regarded as having true scoliosis. The majority of scoliosis cases are mild, and they might only need to be watched.

Here's a table of common signs of scoliosis, presented briefly:

Evaluation of Scoliosis

1. Clinical Evaluation:

Presentation:

• Spinal deformity, shoulder asymmetry, chest wall/back asymmetry, waist asymmetry (often noticed by parents/teachers).

• Severe cases may present with breathing difficulty.

Adams Forward Bending Test:

• Simple screening test for children (schools/clinics) to identify mild curves.

• Patient bends forward, knees straight, trying to touch toes.

• Normal: Back remains straight.

• Scoliosis: One side of the back becomes prominent/higher due to spinal deviation and rib involvement (crooked spine).

2. Radiographs:

• Whole Spine Standing PA & Lateral View: For curve measurement.

• Side-bending PA X-ray: For evaluating curve flexibility (only for pre-operative planning).

3. MRI Screening (Whole Spine):

Purpose: To rule out spinal cord anomalies such as:

• Arnold Chiari Syndrome

• Syringomyelia

• Diastematomyelia

• Tethered Cord Syndrome

4. CT Scan of the Spine:

Usage: Only in selected cases where deformity is due to:

• Complex congenital anomalies

• Tethered cord anomalies

Understanding Scoliosis Surgery: Fusion vs. Fusionless Procedures

Scoliosis correction surgeries fall into two main types:

1. Instrumented Fusion (Gold Standard)

This involves placing screws, hooks, or wires into the spine, which are then connected to rods. The spine is realigned, and bone grafts help fuse the vertebrae into one solid structure to maintain the correction.

2. Fusionless Surgery (For Younger Children)

Used for early-onset scoliosis (before age 10), this method uses growth rods or guidance systems to control spine curvature while allowing continued growth. Minor adjustments are done every 6 months until final fusion surgery around age 11-12.

Post-Surgery Recovery

Patients typically spend one day in the ICU and 4–5 days in the hospital. Walking begins in 2–3 days, and school can resume in 6–8 weeks. Full physical activity is restricted for 4–5 months. With modern technology and neuromonitoring, the risk of complications is under 1%.

Scoliosis Surgery risks in children

Scoliosis surgery in children, primarily spinal fusion, aims to correct severe curves and prevent progression. While often successful, it carries specific risks that parents should understand:

• Neurological Damage: Though rare, this is the most serious Scoliosis Surgery risk, ranging from temporary numbness/weakness to paralysis, affecting sensation, strength, or even bowel/bladder control.

• Failure of Fusion (Pseudarthrosis): The bones might not fully fuse, leading to continued movement and pain, potentially requiring more surgery.

• Hardware Complications: Rods, screws, or hooks can break, loosen, or shift, causing pain or needing revision surgery.

• Loss of Spinal Flexibility: The fused sections of the spine lose their ability to bend and twist, reducing overall spinal mobility.

• Infection: Can occur at the surgical site, ranging from superficial to deep, potentially requiring antibiotics or further surgery.

• Excessive Blood Loss: Significant bleeding during surgery may necessitate blood transfusions.

Throughout recovery, physical therapy may be recommended to regain strength and mobility. Emotional support is also vital during this challenging time.

If your child has been diagnosed with scoliosis, know that you’re not alone—and you’re not powerless. Whether you choose monitoring, bracing, therapy, or surgery, the most important thing is timely and informed care.

At Manipal Hospitals Global, we specialise in customised scoliosis treatment plans tailored to your child’s age, condition, and growth stage. Reach out today to consult the best doctors for scoliosis surgery treatment and ensure your child has the best possible start to a straighter, healthier future.