Deciding on surgery and preparing for it

When is surgery recommended?

In growing children, surgery is usually recommended when the curve exceeds 45–50 degrees or progresses despite a brace. Curves of this size can continue to progress slowly even after growth has finished. In adults, the decision depends on pain, symptoms of nerve compression, balance problems and progression.

What happens during the operation?

The most common procedure is posterior spinal fusion. The curve is corrected with screws and rods, and over time the vertebrae in the corrected section fuse into a single block of bone. The fused section no longer bends, but the rest of the spine keeps its movement.

Throughout the operation, the function of the spinal cord and nerves is monitored continuously using a technique called neuromonitoring. In selected patients, other methods that allow growth, such as tethering, may also be considered.

Before surgery

• Blood tests and heart and lung assessments are carried out; an MRI is done if needed.
• Tell your team about all the medicines and supplements you take; some may need to be stopped before surgery.
• Smoking impairs wound and bone healing and should be stopped before surgery.
• On the morning of surgery, do not eat or drink after the time you are given.
• Bring comfortable clothes, non-slip slippers and something to pass the time to hospital.

Risks

As with any operation, there are risks such as infection, bleeding, implant-related problems and, rarely, nerve injury. Your team takes the necessary precautions to reduce these risks. Discuss the risks that apply to you in detail at your pre-operative consultation, and ask all your questions.