Surgery is an option used primarily for severe scoliosis (curves greater than 45 degrees) or for curves that do not respond to bracing. There are two primary goals for surgery: to stop a curve from progressing during adult life and to diminish spinal deformity.

Until the last few decades, patients undergoing scoliosis surgery endured intensive surgery, treatment and casting, as well as months of slow recuperation. Since that time, spinal surgery pioneers such as Paul Harrington, Yves Paul Cotrel and Jean Dubousset have made great strides in improving the techniques and instruments used in surgery and post-operative care for patients with scoliosis.

There are different techniques and methods used today for scoliosis surgery. The most frequently performed surgery for adolescent idiopathic scoliosis involves posterior spinal fusion with instrumentation and bone grafting. This kind of surgery is performed through the patient's back while the patient lies on his or her stomach. Two common instrumentation techniques are called Cotrel-Dubousset (CD®) instrumentation (rod rotation technique) and COLORADO 2™ instrumentation (translation technique). During these types of surgery, the surgeon attaches a metal rod to each side of the patient's spine by using hooks attached to the vertebral bodies. Then, the surgeon fuses the spine with a piece of bone from the patient's hip (a bone graft). The bone grows in between the vertebrae and holds them together and straight. This process is called spinal fusion. The metal rods attached to the spine ensure that the backbone remains straight while the spinal fusion takes place.

The operation usually takes several hours. With recent advances in technology, most people with idiopathic scoliosis are released within a week of surgery and do not require post-operative bracing. Most patients are able to return to school or work in two to four weeks after the surgery and are able to resume all pre-operative activities within four to six months.

Another surgery option for scoliosis is an anterior approach, which means that the surgery is conducted through the chest walls instead of entering through the patient's back. The patient lies on his or her side during the surgery. During this procedure, the surgeon makes incisions in the patient's side, deflates the lung and removes a rib in order to reach the spine. This approach allows the surgeon to operate higher up in the spine than through posterior approaches, and studies have shown favorable results with this type of surgery. Video-assisted thoracoscopic surgery allows surgeons to enhance their vision of the spine and to conduct a less invasive surgery than with an open procedure. Most patients require bracing for several months after this surgery.

To further explore techniques for scoliosis surgery and to decide which surgery is best for you or your child, consult a specialist. For a list of orthopaedic specialists in your area, please visit our physician locator.

This 15-year-old female was diagnosed with scoliosis at age 12. Despite bracing, her curve progressed to 55 degrees. Surgery was chosen because her curve was still at risk of further progression with growth and her long-term natural history was unfavorable. Posterior spinal instrumentation and fusion produced an excellent correction of her curve.

It is important that you discuss the potential risks, complications, and benefits of the Cotrel-Dubousset (CD®) and COLORADO 2™ instrumentation with your doctor prior to receiving treatment, and that you rely on your physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

Published: April 16, 2002

Updated: November 05, 2007

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 physician's judgment. Only your doctor can determine whether you are a suitable candidate for this treatment.

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