How much correction do you expect to achieve
Dr. Thomas G. Lowe
Woodridge Orthopaedics & Spine Center, P.C.
Correction of the deformity involves stiffening a segment of the spine but also means preserving as much of the flexibility of the spine as possible. Usually that means if there is more than one curve, correcting only the most severe of the curves surgically, and relying on the balancing system of the body to provide correction of the other less severe curves. The surgery now can be usually done without applying any kind of a brace after the surgery. Generally the curves can be corrected approximately 75% in adolescents. The goals and expectations are much less if surgery is done as an older adult. Therefore, if surgery is recommended, it is best done as an adolescent to maximize the expectations.
A correction anywhere from 50 to 80 percent can be achieved with a flexible curve.
New York, NY
The amount of correction depends upon a number of factors including the degree of deformity, the levels of scoliosis and the stiffness of the spine. The type of scoliosis can also affect the degree of correction that can be safely obtained. In general, for idiopathic scoliosis an average amount of correction is around 50-75%. The primary goal of surgery is not a straight spine on an X-ray and excessive correction can lead to severe problems.
Usually we can correct the curve by 50% with the instrumentation that we use, but it depends on how stiff your particular curve is.
Glen Burnie, MD
The amount of curve correction possible depends on the flexibility of the scoliosis. Curves that are more flexible can be corrected to a greater degree than stiffer curves. A special series of x-rays, called bending films, are usually taken prior to surgery to determine the flexibility of the scoliosis. For adolescents, the bending films closely depict the correction possible through surgery. Too much correction risks stretching the spinal cord and causing injury. As a result, most surgeons limit correction to around 60 percent of the original curve. Achieving a balanced posture is a very important goal of scoliosis correction. Adults have stiffer curves that cannot be corrected to the same magnitude as younger more flexible ones. Important goals for adult scoliosis surgery are to achieve a balanced posture, decompress pinched nerves, and decrease pain.
With the latest spinal instrumentation techniques, surgeons no longer have to accept minimal or modest scoliosis correction. From our most recent data, we are averaging 72% correction in idiopathic scoliosis and 78% correction for degenerative scoliosis using the new Multi-Planar Adjusting instrumentation. This compares to 48% curve correction we were achieving just 3 years ago using standard spinal instrumentation.
Los Angeles, CA
In children, adolescents, and young adults, the spine maintains its flexibility and higher percentages of correction can be achieved. Newer instrumentation provides greater corrective forces than older techniques (e.g., HARRINGTON® rods) to straighten the spine. In these younger patients, corrections up to 80 percent are commonly achieved. With age, the spine becomes less flexible, making high percentage corrections more difficult to achieve.
Texas Scottish Rite Hospital Orthopedic Group
An average amount of correction is usually between 50-80%, but the important thing to remember is that a degree of correction which safely achieves spinal alignment and trunk balance is sufficient, and attempts to achieve excess correction can be dangerous.
New York, NY
This depends on the severity and stiffness or rigidity of the curvature prior to surgery. Correction achieved in children and adolescents is generally much greater than that achieved in adults. The reason for this is that the adult spine becomes stiffer with age due to degeneration of the discs and the formation of bone spurs. Often, corrections of sixty to seventy percent or more can be achieved in children, particularly with anterior procedures. The correction achieved in adults generally approaches fifty percent.
St. Louis, MO
The amount of correction depends on multiple factors: patient age, curve size, location and flexibility, presence of other curves, other medical problems, previous surgery, etc. Judicious correction of the scoliosis is always indicated, as overcorrection of the spine can lead to temporary or permanent neurological injury, such as nerve root deficits or paralysis.
Curve correction is critical to the patient and surgeon alike. However, it is more important to balance and stabilize the spine safely. Correction must be considered along three dimensions: rib prominence, or rotation; shoulder level and sagittal – or side – alignment. Taking all of this into account, curve correction of 50-75% is typically expected.
The amount of correction is dependent on the flexibility of the curve and needs to be balanced with any residual curves that will be unfused. Each patient's amount of correction is different and in general we expect somewhere between 40% and 50% correction at a minimum.
New York, NY
University of Utah Department of Orthopaedic Surgery
The amount of correction one obtains is dependent upon how stiff a given curve is, and the age of the patient. Typically, curves get corrected approximately 70%, but there are exceptions. What we hope to accomplish with surgery is to correct the curve and maintain balance of the spine as you would look at it from both the front and side views. We accomplish this correction and balance by using instrumentation on the curve and fusion.
The commentary above recounts the experiences of these physicians. Medtronic invited them to share their stories candidly. Keep in mind that results vary; not every patient's response is the same. Talk with your doctor to learn more about any products that are mentioned above.
It is important that you discuss the potential risks, complications and benefits of spinal surgery with your doctor prior to receiving treatment, and that you rely on your doctor's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.