What is Scoliosis and When Do You Need Surgery?
Scoliosis means your spine curves to the side instead of going straight up and down your back. Think of it like an “S” or “C” shape instead of a straight line. Many people with small curves live normal lives without any treatment.
But sometimes scoliosis gets worse and causes problems. Your doctor might suggest surgery if you have:
- Pain that won’t go away even after trying other treatments
- Trouble breathing because the curve squeezes your lungs
- Your curve keeps getting worse over time
- Numbness or weakness in your arms or legs
- Very large curves in your spine (usually over 45-50 degrees in teens or over 50 degrees in adults)
The goal of surgery is to stop your curve from getting worse, reduce your pain, and help you move better.
Traditional Surgery or Minimally Invasive Surgery: What’s the Difference?
Traditional Open Surgery
For many years, doctors fixed scoliosis the same way:
- One big cut down the middle of your back (8-12 inches long)
- Cut through back muscles to reach your spine
- Put in metal rods and screws to straighten your spine
- Surgery takes 6-12 hours
- Stay in the hospital for 5-7 days
- Takes longer to heal because muscles were cut
This method works well, but it may be harder on your body.
Minimally Invasive Surgery
Now, doctors can fix scoliosis with much smaller cuts and less disruption to your body. There are two main ways to do this:
Back Approach (Posterior):
- Uses smaller cuts on your back (ranging from a few inches to longer incisions, depending on your case)
- Gently moves muscles aside instead of cutting them
- Uses tiny cameras and special tools
- Less pain and faster healing
Side Approach (Lateral):
- Small cuts on your side
- Works through the spaces between your spine bones
- Can put in bigger, stronger support pieces
- Straightens your curve better because it works from the side where your curve sticks out the most
- Faster recovery because your back muscles are never disturbed
Why the Side Approach Works So Well: Think of your scoliosis curve like a bent stick. If you want to straighten it, you get better results by pushing from the side that sticks out (the convex side) rather than from behind. That’s exactly what the side approach does – it fixes your curve from the best angle.
Combined Approach: Many times, doctors use both methods together. The side approach does most of the work to straighten your spine, then they might use a small back approach to add final support with rods and screws.
How this Minimally Invasive Surgery Works
Here’s what happens during minimally invasive scoliosis surgery:
Step 1: Side Surgery (Main Part)
- 1 small cut is made on your side where your curve sticks out most
- Your surgeon works between your belly muscles without cutting any muscles
- The damaged disc material between your spine bones is removed
- Special cages are inserted that immediately start straightening your spine – these cages make your spine taller and straighter
Step 2: Back Surgery (If Needed)
- Small cut(s) are made on your back
- Back muscles are gently moved aside
- Rods and screws are added to keep everything in place
- Final adjustments are made
Step 3: Finish Up
- All of the cuts are closed with stitches
- Bandages are applied
You’ll be asleep the whole time. The lateral approach does most of the work to fix your curve. The back part (if needed) just adds extra support.
8 Big Benefits of the New Surgery
The new minimally invasive surgery has many advantages:
- Much smaller scars – tiny cuts instead of one big one
- Less muscle damage – muscles are moved, not cut
- Lower chance of infection – smaller cuts heal better
- Less pain after surgery – less pain medication needed
- Shorter hospital stay – often just 2-3 days
- Get back to life faster – return to work and activities sooner
- Stronger muscles later – back muscles stay healthy
- Much less blood loss – significantly lower risk of needing a blood transfusion (open surgery almost always requires transfusion)
Remember, this new surgery isn’t right for everyone. Your doctor will look at your specific curve and health to decide what’s best for you.
What to Expect During Recovery
Getting better after minimally invasive scoliosis surgery happens in stages:
First Week
- Stay in hospital 2-4 days (open surgery typically needs 5-7 days)
- Start walking the same day as surgery
- Learn safe ways to move around
Weeks 2-6
- Take gentle walks and do simple exercises
- Slowly return to non-intensive daily activities
- Don’t bend, twist, or lift heavy things (nothing heavier than a milk jug)
- See your doctor to check how you’re healing
Months 2-3
- Start harder exercises to get stronger
- Go back to desk jobs or light work
- Still no sports or heavy activities
- Keep seeing your doctor regularly
Months 4-12
- Slowly return to daily activities
- Your bones keep growing together and getting stronger
- Get scans to make sure everything is healing
- If you have a physical job or play sports, you might need 6-12 months before doing everything
The key is staying active within the limits your doctor gives you. Everyone heals at their own pace.
Possible Risks You Should Know About
Even though minimally invasive surgery is incredibly safe and has high success rates, all surgeries have a minor chance of risks, including:
- Infection where cuts were made
- Nerve irritation that can cause numbness or tingling
- Hardware problems – screws or rods might come loose
- Bones not growing together properly (called “non-union”)
- Ongoing pain that doesn’t go away
- Need for additional surgery in some cases to address complications or achieve better results
- Reactions to materials used in surgery (very rare)
Your doctor will talk about these risks with you before surgery and answer all your questions.
Are You a Good Candidate for This Surgery?
The new minimally invasive surgery works best for certain people:
Good Candidates for Minimally Invasive Surgery Usually Have:
- Small to medium curves (20-70 degrees)
- Good overall health
- Don’t smoke (or willing to quit)
- Ready to do physical therapy
- Realistic expectations about results
Traditional Surgery Might Be Better If You Have:
- Very large curves (over 70 degrees)
- Curves in many areas of your spine
- Very stiff spine that doesn’t bend
- Had spine surgery before that needs fixing
- Health problems that make surgery riskier
Your doctor will examine you and look at your scans to decide which surgery is best for you.
Making the Right Decision
Choosing spine surgery is a big decision. It’s normal to feel worried. Here are ways to make the best choice:
- Ask how many of these surgeries your doctor has done
- Look at before and after scans of patients like you
- Talk about realistic expectations for pain relief and movement
- Get a second opinion if you’re unsure
- Ask about non-surgical treatments you haven’t tried
Remember, surgery should help you live with less pain and move better. Your success depends on both the surgery and how well you follow your recovery plan.
How to Get Started
If you’re thinking about minimally invasive scoliosis surgery, schedule a meeting with one of our spine specialists. During your visit, we will:
- Review your medical history and past treatments
- Examine your back and talk about your symptoms
- Look at your X-rays and other scans
- Discuss if minimally invasive surgery is right for you
- Answer all your questions about surgery and recovery
For many people with scoliosis, this new minimally invasive surgery can be a great option. It offers relief with less recovery time than traditional open surgery.
FAQ
How long does minimally invasive scoliosis surgery take?
Most procedures take 2-6 hours, depending on how complicated your curve is. This is usually shorter than traditional open surgery, which can take 6-12 hours or more.
Will I need physical therapy after surgery?
Yes, physical therapy is very important for recovery. Most patients start therapy 4-6 weeks after surgery. Your therapist will create a program just for you to help rebuild strength and flexibility.
What kind of pain medicine will I get after surgery?
You’ll get prescription pain medicine for the first 1-2 weeks, then switch to over-the-counter pain relievers as needed. Most patients need less pain medicine than with traditional surgery because there’s less muscle damage.
Does insurance cover minimally invasive scoliosis surgery?
Most insurance plans cover this surgery when it’s medically necessary. Coverage depends on your specific plan, how severe your condition is, and whether conservative treatments have failed. Our insurance specialists can help check your coverage and explain costs.
When can I drive again after surgery?
Most patients can drive again 2-4 weeks after surgery, once they’ve stopped taking prescription pain medicine and can comfortably turn their head and body to check blind spots. Your surgeon will tell you when it’s safe based on your recovery.
Will I have visible scars?
The small cuts used in minimally invasive surgery create much less noticeable scars than traditional surgery. Most patients have several small scars about 1-2 inches long instead of one long scar. These usually fade a lot over time.
Can scoliosis come back after surgery?
Once your spine bones grow together (fuse), the part that was fixed can’t develop scoliosis again. However, sometimes areas above or below the surgery might develop curves later. Regular check-ups help watch your spine health over the years.
What’s the difference between side surgery and back surgery?
Side surgery (lateral) goes through cuts on your side and works through the disc spaces between spine bones. This approach gives the best curve correction and never touches your back muscles.
Back surgery (posterior) uses small cuts on your back and gently moves muscles aside.
Many complex cases use both – the side surgery does most of the curve correction, while a small back surgery adds final support with rods and screws.