Scoliosis correction surgery is a major operation to straighten and stabilise a curved spine using metal rods, screws, and bone grafting. It is performed for progressive spinal deformities that have not responded to bracing or observation.
An incision is made along the midline of the back over the curved segment. Screws are placed into the vertebrae throughout the curve. Rods are then connected to the screws and used to correct the curvature. Bone graft is placed along the spine to promote fusion of the vertebrae into their corrected position. The operation typically takes four to eight hours depending on the complexity and length of the fusion.
Surgery is recommended for progressive scoliosis curves exceeding 40–50 degrees, curves that are causing pain or respiratory compromise, and curves that are likely to progress. It is most commonly performed in adolescents with idiopathic scoliosis but is also performed in adults for degenerative scoliosis.
Bracing (for growing adolescents with curves of 25–40 degrees), physiotherapy and exercise (Schroth method), pain management, and observation. Bracing can prevent progression but does not correct an established curve.
Thorough pre-assessment including pulmonary function tests and cardiac assessment. Full-length spine X-rays and MRI. Blood should be available for transfusion. This is a major operation requiring careful planning.
The aim is to correct the spinal curvature, prevent further progression, improve spinal balance, and in some cases improve appearance and respiratory function. Typical correction is 50–70% of the curve. The corrected position is maintained by the fusion.
The fused segment will be rigid. This is expected and usually well compensated.
Significant pain is expected in the first few weeks and is managed with strong pain relief.
Significant blood loss is common. Blood transfusion may be needed.
Risk to spinal cord or nerve roots. Neuromonitoring is used to reduce this risk. Occurs in approximately 1% of cases.
Deep wound infection in approximately 2–3%. May require further surgery and prolonged antibiotics.
Failure of fusion. May require revision surgery.
Screws may loosen or rods may break, particularly if fusion does not occur.
Loss of normal lumbar lordosis causing difficulty standing upright.
The spine may develop a new curve above the fusion.
Including pneumonia, particularly in patients with pre-existing respiratory compromise.
General anaesthesia with full neuromonitoring (motor and sensory evoked potentials) throughout surgery. Positioned prone on a specialised frame.
Hospital stay of five to seven days. Walking begins within a day or two of surgery. A brace may be worn for several months. Return to school or desk work at four to eight weeks. Sports at six to twelve months, with some high-impact activities restricted. Full recovery takes six to twelve months.
Regular follow-up with X-rays at six weeks, three months, six months, one year, and annually for several years. Long-term monitoring for adjacent segment problems.
Surgery typically corrects 50–70% of the curve. Complete correction is not the goal — the aim is a balanced, stable spine.
Most daily activities and many sports are possible. High-impact activities and contact sports may be restricted depending on the extent of fusion. Swimming, cycling, and walking are encouraged.
Typically four to eight hours, depending on the number of levels fused and the complexity of the curve.