When to Consider a Scoliosis Surgery

In order for a building to stand, firm structures like columns hold them together to make the buildings stronger and erect. In the architecture of our bodies, our bones may hold our bodies together, but it is our spines that keep us standing.

Without the spine, we would not be able to put on our shoes or exercise to keep our bodies fit and healthy. Buildings with weak columns will easily crumble and might not even stand at all while bodies with abnormally curved spine have this condition called scoliosis.

Scoliosis gives a person slanted shoulders, visibly curved spine which may take the form of the letter S or C, and prominent ribcage. The cause of scoliosis is usually not found, yet when it is, it is most probably because of cerebral palsy, muscular dystrophy or Marfan syndrome.

Diagnosis for scoliosis can be done through x-ray or physical examination of the spine, ribs, hips and shoulders. Two to four percent of children are normally diagnosed with scoliosis at the age of 10 to 16. However, it is also possible to be born with this condition. Scoliosis is 10 times more likely to progress with girls compared to boys, which may lead to them needing surgery or bracing. On the other hand, scoliosis in adults causes them to have back pains, which makes pain relief the main focus of their treatment.

Aside from back pain, the complications brought by scoliosis can be emotional issues, lung and heart problems, and nerve compression. Emotional issues may probably be caused by the negative body image a person with scoliosis can have due to his or her visibly curved spine or back brace. This usually happens with teenagers.

When scoliosis is severe, the ribcage can be pushed against the lungs and heart. This causes the person to experience breathing problems and difficult blood circulation. Nerve compression, on the other hand, may contribute to back and leg pain or numbness, urinary and bowel incontinence, and erectile dysfunction in men.

The most common treatments for scoliosis include bracing and surgery. However, it is highly recommended by spine specialists to undergo surgery to prevent the curvature of scoliosis from worsening. This is especially applicable to children with scoliosis.

There are some cases where their spinal curvature stops them from growing and this makes surgery the more preferable treatment.

Dr. Larry Acuña, spine and orthopedic surgeon at The Medical City (TMC), says one should consider scoliosis surgery when he has more than 50 degrees Cobb angle, or when the patient is recalcitrant to bracing, with severe rib hump, with restrictive lung disease secondary to rib anomaly, and already experiencing severe back pains. The Cobb Angle is used as a standard measurement to determine and track the progression of scoliosis.

The main goals of scoliosis surgery are to stop a curve from progressing and to correct spinal deformity.

“Scoliosis surgery is either Instrumented Anterior Spinal Correction and fusion or Instrumented Posterior Spinal correction and fusion; and in more severe cases both anterior and posterior spinal correction and fusion,” says Dr. Acuña.

The anterior approach to scoliosis means that the surgeon will approach the spinal column from the front of the spine. On the other hand, posterior spinal instrumentation with fusion is performed through the patient's back while he lies on his stomach.

Dr. Acuña adds that orthopedic spine surgeons with special training in spine deformity surgeries can perform scoliosis surgery.

The Spine Surgery Unit under TMC Department of Orthopedics offers expert diagnosis and treatment for patients with scoliosis and other problems related to the spine. Follow-up care is also part of the services offered to help patients return to their normal activities as soon as possible.

“Our goal at The Medical City is to provide our patients with the safest, high quality, and leading edge care for children and adults with spinal deformities," says Dr. Acuña.

Because of the often-debilitating nature of spinal cord injuries, a specialized level of surgical expertise and care is a prerequisite in dealing with spine conditions. The Spine Surgery Unit oversees the treatment of common spine conditions including traumatic injuries, congenital anomalies, deformities (such as scoliosis), infections and tumors.

For inquiries about spine surgery, please visit or call the Orthopedic Multispecialty Center located on the Ground floor of The Medical City’s Podium Building, tel nos. 988-1000/988-7000 ext.6521.

The Orthopedic Multispecialty Center offers consultation services for orthopedic subspecialties which include Sports Medicine and Arthroscopy, Joint Replacement Surgery, Hand and Microvascular Surgery, Spine Surgery, Pediatric Orthopedics, and Orthopedic Oncology.