Scoliosis 3DC, 3 Baldwin Green Common, Suite 204, Woburn, MA 01801, USA
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Recent reviews discussing risks and benefits of spinal fusion surgery in patients with scoliosis have lead to the conclusion that evidence for spinal fusion is lacking. Long-term follow-up studies have shown a high rate of complications due to surgical intervention. A long-overdue debate has ensued about the pros and cons of spinal fusion surgery. The aim of this paper was to discuss treatment options for adolescent idiopathic scoliosis patients.
Untreated adolescent idiopathic scoliosis results in limited physical impairment during adulthood. Typical primary complaints of concern in adults with scoliosis are back pain and emotional distress over one’s postural appearance. As a result, spinal fusion surgery should not be regarded as mandatory upon achieving a certain Cobb angle.
The reality is, until recently, very few have ever challenged surgery for adolescent idiopathic scoliosis in a field dominated and managed by spinal surgeons. Most of the patients and parents have a natural aversion to surgery for scoliosis, yet many spinal surgeons lead patients to believe that there is no other choice when it comes to scoliosis.
Full disclosure about the potential unknowns of surgery in the short- and long-term should be mandatory, so families may weigh the myriad of unknowns against the perceived benefits of surgery. Examples of the risks of surgery include, but are not limited to, post-surgical pain, hardware failure including breakage, corrosion, advanced degeneration, late infections, and the potential for one or more revision surgeries.
In the field of adolescent idiopathic scoliosis, certainly most of the physicians would agree that there are still many unknown factors. A few ideal treatment protocols exist for the scoliosis, especially from the perspective of the adolescent patient and his/her parents. It is for this reason that a dialogue is essential and must be kept with the goal that treatments should always incur the least potential harm and maximum potential benefit in both the short- and long-term.