Spinal Fusion for Scoliosis: Correcting Spinal Curvature and Enhancing Quality of Life

Spinal fusion surgery, or SFS, is the surgical treatment for scoliosis. It includes fusing two or more vertebrae together to help straighten the spine and stop the curvature from progressing. 

Most people diagnosed with scoliosis don’t need surgery; many don’t require treatment at all. However, spinal fusion surgery is reserved for those with severe scoliosis, or patients who develop scoliosis during their infancy. Without treatment for this type of scoliosis, curvature of the spine may progress and cause health complications like pain, reduced mobility and heart and lung damage.

What is scoliosis?

Scoliosis is a condition where the spine curves to one side of the body. The curvature can occur in any part of the spine but is typically present within either the upper spine or lower back. Depending on the degree of the curvature, a patient may need to wear a brace. If the curvature is especially pronounced, surgery could be necessary.

Scoliosis as a condition is most common among those in the late stages of childhood or in the early teenage years when the human body is still growing quickly. Additionally, scoliosis can present itself in infants and is called infantile scoliosis. This condition affects those under the age of three.

Scoliosis is more common in females rather than males and is not always noticeable—however, some people with this condition may lean to one side, have uneven shoulders or unbalanced hips due to the spine curvature. For a doctor to diagnose scoliosis, they use an approach called the Cobb angle, which is a measure of the curvature. Diagnosed scoliosis must have a curvature of at least 10 degrees. 

Different types of scoliosis: Structural versus non structural 

There are two different kinds of scoliosis: structural scoliosis and non structural scoliosis. For those living with structural scoliosis, they experience one of three kinds of structural curvatures: 

• Idiopathic Scoliosis: This is the most common type, and its exact cause is unknown. It often develops during adolescence, and there is no single identifiable factor responsible for its occurrence. Idiopathic scoliosis can be further categorized into three subtypes based on age of onset: infantile, juvenile, and adolescent idiopathic scoliosis.
• Congenital Scoliosis: This type of scoliosis is caused by abnormalities in the development of the spine before birth. It results from malformations in the vertebrae and may be present at birth.
• Neuromuscular Scoliosis: This type is associated with conditions that affect the nerves and muscles, such as cerebral palsy, muscular dystrophy, or spinal cord abnormalities.

Additionally those diagnosed with nonstructural scoliosis—also known as functional scoliosis—have scoliosis that originates from one of two ways: 

• Postural or Compensatory Scoliosis: This type occurs due to factors outside the spine, such as muscle spasms, leg length discrepancy, or other issues causing an imbalance. The spine appears curved, but the curvature is reversible once the underlying cause is addressed.
• Disorders or injuries: Conditions like osteoporosis or trauma to the spine can lead to scoliosis.

Although the cause of idiopathic scoliosis is unclear, it’s believed to involve a combination of genetic, environmental, and hormonal factors. It often runs in families, suggesting a genetic component, and certain hormonal factors related to growth spurts during adolescence may play a role in its development.

How is scoliosis treated?

Scoliosis treatment depends on various factors, including the type of scoliosis, the severity of the curvature, the age of the individual, and the underlying cause. The most common approaches to treating scoliosis include observation, bracing and physical therapy. However, for severe cases of scoliosis where the curvature is progressive, causing pain or significantly impacting lung and heart function, surgery is required through the form of a spinal fusion. 

Spinal fusion for scoliosis treatment 

Spinal fusion for scoliosis is a surgical procedure that includes the fusion of two or more vertebrae to either stabilize or correct a curvature in the spine. The goal of the surgery is to reduce the curvature, prevent further progression of scoliosis and alleviate symptoms. Spinal fusion is most commonly used in cases where patients with severe scoliosis haven’t responded well to non-surgical interventions.

How is a spinal fusion performed? 

To begin, the surgeon first exposes the spine through an incision in the back. The vertebrae involved in the curvature are then prepared for fusion. This typically involves removing the discs between the affected vertebrae. Bone graft material is often used to facilitate fusion. The graft may come from the patient’s own bone (autograft), a donor (allograft), or a synthetic material. The bone graft helps stimulate the growth of new bone, fusing the vertebrae together.

In addition to bone grafts, metal rods, screws, and other instrumentation are often used to stabilize the spine during the fusion process.

Metal rods and screws are attached to the spine to hold the vertebrae in the corrected position until the fusion process is complete. This helps maintain stability and alignment during the healing period. Over time, the bone graft material stimulates the growth of new bone between the vertebrae, fusing them together. This fusion process stabilizes the spine and prevents further curvature.

When is spinal fusion necessary to treat scoliosis?

The decision to undergo spinal fusion is typically based on several factors and is usually considered when other non-surgical interventions have not been successful or when the scoliosis is severe and progressive. 

Spinal fusion could be recommended when the curvature of the spine is severe, typically exceeding 40-50 degrees.This kind of curvature leads to cosmetic deformity, functional impairment, and, in some cases, compression of internal organs. If the curvature is rapidly progressing, especially during periods of growth, and non-surgical interventions such as bracing have not been effective, spinal fusion may be recommended to prevent further progression.

Spinal fusion may also be considered when scoliosis is associated with significant pain and discomfort that cannot be adequately managed with non-surgical measures. In cases where severe scoliosis affects the function of the lungs or heart, spinal fusion may be recommended to alleviate pressure on these organs and improve respiratory and cardiac function.

Spinal fusion recovery

Recovery from spinal fusion for scoliosis can vary, but it often involves a period of restricted activity and physical therapy to regain strength and flexibility. The patient may need to wear a brace for a period following surgery to provide additional support during the initial stages of healing.

For patients and their families, it’s important to know that patients recover at different rates, depending on the type of surgery they’ve had and how much of their spinal cord was affected. A few days after surgery, most patients will have stayed in the hospital. Once they meet certain physical requirements like being able to walk and shower on their own, they’ll be discharged along with instructions on how to continue their recovery.

For children, most are able to go back to school after three to four weeks of having their surgery. However, it’s recommended they don’t engage in sports or physician activity for two to six months, depending on what their physician advises.

Within six to 12 months after spinal fusion surgery, the vertebrae should be solid and stable, but it’s important to note that the affected area of the spine won’t be able to bend or grow beyond its current size. Once the patient has been cleared by their clinician, they can go back to playing activities like contact sports and more.

Spinal fusion in New Jersey

For more than 25 years, the experienced physician team at New Jersey Brain and Spine has delivered highly-skilled and compassionate care to more than 40,000 patients with complex brain, spine and neurological conditions. Please contact us today to decide if we are the right option for your care and treatment.

We also offer an expert second opinion service should you wish to discuss your treatment options. For more information, or to request a second opinion, reach out to us immediately by calling 201-342-2550 or emailing us at secondopinion@NJBrainSpine.com