The Department of Neurosurgery at Brigham and Women’s Hospital has dedicated scoliosis experts that will work with you and your family to determine the best treatment option that meets your individual needs, including the latest minimally invasive surgical options.
Scoliosis Treatment Options
Non-Surgical Options
- Mild curves that have no symptoms found on x-ray likely will require no treatment
- Moderate and painful scoliosis patients may benefit from physical therapy to improve the flexibility and strength of the spine to reduce the symptoms. Bracing is also a possibility depending on the nature and severity or progressing nature of the curve.
Surgical Options
- Severe pain and disability as a result of the severe scoliosis/spinal deformity that failed extensive conservative treatments may require surgery.
- Progressive neurological deficit as a result of the scoliosis/spinal deformity requires immediate surgical intervention.
- Severe curves that are progressive may require surgery to stabilize and correct the progressive deformity.
Surgical Techniques
- Pedicle Subtraction Osteotomy (PSO) / Smith Peterson Osteotomy (SPO)
- Removal of a complex segment of bone surrounding important nerves and spinal cord in order to correct abnormal curvature of the spine
- Minimally Invasive Surgical Options – Oblique lumbar Interbody Fusion (OLIF)/Direct Lateral Interbody Fusion (DLIF).
- Novel technique to place bone spacers using a small incision in the flank, in order to “tilt” the spine and correct abnormal curvatures
Interoperative Image Guidance
- O-Arm – Stereotactic navigation using intraoperative CT Scan in order to safely localize for surgery and place screws into bone (also known as “GPS of the spine”). Has been demonstrated to significantly reduce the risk for spinal hardware related complications.
- Advanced Intraoperative Neuromonitoring (special monitoring of spinal cord function while patient is asleep in the operating room, in order to prevent injury to the spinal cord during surgery)
- High definition microscopic surgery
Scoliosis Treatment Surgical Risks
Scoliosis surgery is complex and therefore, there are important risks to consider. Your surgeon, who is an expert in complex spinal surgery, will discuss these risks with you prior to your surgery. Every patient is different, but common known risks are the following:
- Implant failure: A surgeon will use an implant to fuse your spine and these implants can fail (i.e. break, dislodge, pinch) compressing the nerve root and causing pain or disability.
- Nerve damage: Spinal surgery necessitates working around the spinal cord and nerves; damage as a result of chronic nerve compression or due to surgery can result in patients experiencing a variety of neurologic complications such as loss of sensation, feet or leg weakness, or loss of bowel and bladder control.
- Chronic pain: Regardless of surgical outcome, patients may still develop lower back pain at any point. Following the treatment plan and your physician’s recommendations can help reduce this pain and improve your overall quality of life.
- Infection: All surgical interventions carry the risk of infection. Scoliosis surgery is very invasive which increases this risk to approximately 10%.
Preparing for Scoliosis Surgery
Spinal surgery can take a toll on your emotional & physical well-being. You should speak with your surgeon regarding any concerns you may have as this will help your surgeon to develop a better treatment plan with you to meet all your needs. Here are some things to think about:
- Exercise – Both pre- and post-surgery plan.
- Diet – Discuss your diet and nutritional needs and prepare a meal plan. Reheating food that is already cooked/prepared reduces stress and strain.
- Personal Hygiene – Your recovery period may last a few weeks, so prepare accordingly (i.e. cut/wash your hair) and stock up on the necessities, especially if you live alone.
- Smoking Cessation – Smoking can prevent your body from healing and your surgeon may require you to stop before surgery.
- Recovery Environment – Plan for a space that is close to the bathroom and has no stairs, a comfortable chair, allows for room for any equipment, and anything else that will help you to stay as comfortable as possible. Check with your surgeon to see what the hospital provides.
- Pack for your hospital stay – You will be admitted to the hospital and may stay several days. Please speak with your surgeon to determine how long and plan accordingly. We recommend leaving any valuables at home but having some reading material, travel sized toiletries, and loose-fitting clothes tend to be essential to reducing stress and improving your inpatient experience.
Recovery and Prognosis Post Scoliosis Surgery
Your surgeon will review with you what to expect after your surgery ranging from diet to incision care to pain control. Since every patient is different, it is important to discuss your individual treatment plan with the care team prior to surgery so you can mentally and physically prepare
Additional Scoliosis Resources
Our Scoliosis Experts
Our multidisciplinary team with deep expertise in treating scoliosis includes:
Surgeons
Physiatrists
Pain Specialists
Contact Us
To schedule an appointment with a physician in the Adult Scoliosis Surgery Program, please contact our Patient Coordinator at (617) 732-6600. We see new patients with a scoliosis diagnosis as soon as the next business day.
If you are a physician seeking to refer a patient to the Adult Scoliosis Surgery Program, please call (617) 732-6600 or you can access our physicians’ office phone numbers. To contact one of our physicians with a question, patient referral or second opinion, you may also email: BWHNeurosurgery@partners.org.
