How do I know if my child needs surgery for scoliosis?

In a child, surgery for scoliosis is driven by the anatomy of the curve. In children, doctors try to stave off scoliosis surgery by predicting which curves are going to be problematic when the children become adults. If a child has a curve that is going to be a problem, surgery should absolutely be performed in childhood, rather than waiting until the curve is massive and stiff.

Internationally, 50 degrees is the line in the sand for pediatric surgery. The vast majority of curves larger than 50 degrees do progress when the children are adults. Smaller curves in adulthood are not associated with long-term disability or back pain. Therefore surgical intervention in childhood is not recommended for curves under 50 degrees.

The indication for surgery is done based on a degree of curvatures (usually over 40 to 45 degrees) and their progression. The curvatures that progress rapidly, in spite of bracing, might need to be surgically treated. The younger the child and the larger the curvature, the higher the likelihood that surgical treatment will be necessary.

Scoliosis is defined as a lateral curvature of the spine. The most common form is in children 10 and older and is called adolescent idiopathic scoliosis (AIS). The primary goal of surgical treatment in treating AIS is prevention of curve progression through spinal fusion to prevent complications caused by compression of the heart and lungs. Curvature of the spine is measured and surgical correction is indicated for children with curves greater than 50 degrees and even some with angles between 40 and 50 degrees.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.