When is surgery required or considered for scoliosis

As a chiropractor with a special interest in scoliosis, it’s important to recognize that the decision for surgery in scoliosis patients is typically made by orthopaedic surgeons or spinal specialists rather than chiropractors. However, as part of a multidisciplinary healthcare team, chiropractors can play a crucial role in managing scoliosis through conservative treatments and providing supportive care.

Here are some general guidelines and considerations for when surgery might be required in scoliosis patients:

  1. Severity of the Curve: The degree of curvature in the spine is a key factor in determining whether surgery is necessary. In general, surgery may be considered for curves that exceed 40-50 degrees, especially if the curvature is progressive or if it is causing significant symptoms or functional limitations.
  2. Progression of the Curve: If a scoliotic curve is rapidly progressing, particularly during periods of growth (such as adolescence), surgery may be recommended to prevent further curvature and potential complications.
  3. Presence of Symptoms: Surgery might be warranted if the scoliosis is causing severe pain, neurological symptoms (such as numbness, weakness, or tingling), difficulty breathing, or other significant impairments in function and quality of life.
  4. Failure of Conservative Treatment: Before considering surgery, patients typically undergo conservative treatments such as physical therapy, bracing, and chiropractic care to manage symptoms and slow the progression of the curve. If these measures are unsuccessful in halting the progression of scoliosis or alleviating symptoms, surgery may be explored as a more definitive treatment option.
  5. Age and Skeletal Maturity: The age of the patient and the stage of skeletal maturity are important factors in determining the appropriateness of surgery. Surgery may be more commonly recommended for adolescents with progressive scoliosis, while adult patients with stable curves may have different considerations.
  6. Patient and Family Preferences: Ultimately, the decision for surgery should be a collaborative one between the patient, their family, and the healthcare team. It’s important to consider the potential risks, benefits, and alternatives to surgery, as well as the individual patient’s goals and preferences.
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