Scoliosis can be treated both surgically and non-surgically and treatment approaches vary depending on factors such as age and the severity of the curve. At the London Orthotic Consultancy (LOC), we pioneer non-surgical treatment through back bracing and specialist physiotherapy, as spinal surgery is extremely invasive and can have complications.
Several factors will influence whether surgery is recommended by a surgeon and vary from person to person. Often treated as a last resort, surgery is left for the most serious of cases – typically only for curves with Cobb angles of 45° or more. Other considerations to consider include the likelihood of the curve progressing, how much pain or irritation it is causing to the nerves of the spine and the risk of development of more complex medical issues.
Age is also an important factor; surgery for young adults with adolescent idiopathic scoliosis (AIS) has lower complication rates compared with adults with degenerative scoliosis. Surgery for adults is less common and often offered as a last resort to alleviate symptoms of extreme pain or discomfort. Whatever the age group there are risks of complications; these are described in the independent Cochrane review.
Result after scoliosis surgery, © 2008 Weiss and Goodall; licensee BioMed Central Ltd
What does spinal surgery involve?
The operation used to treat severe scoliosis curves is typically spinal fusion surgery; a major procedure which involves moving muscles and realigning the skeleton into place. The curved, deformed vertebrae are fused together into a single bone, putting metal screws and rods into the spine to help straighten it. Surgery typically lasts between 4 and 8 hours depending on the severity of the curve. Bone graft is then taken from other parts of the body and used to cover the implants.
What is spinal surgery recovery like?
Following the operation, it is necessary to spend around a week in intensive care before returning home and the first few days are often uncomfortable. Most adolescents can expect to return to school from 2-4 weeks following surgery, but pain medication may be required up to 6 weeks following. A full recovery from the procedure can take up to a year, as it can take that long for the spine to heal fully.
Spinal fusion surgery causes the fused portion of the back to become permanently stiff, as a result, returning to sports that require large amounts of flexibility (ballet, yoga, gymnastics, dance) or contact (rugby, football, karate, hockey) may take longer.
What are the risks?
Risks of spinal fusion surgery are like that of any other major procedure and include infection, blood clots and anaesthesia complications. The added risks include permanent nerve damage to the spine and paralysis.
Non-surgical Bracing Treatment
At the London Orthotic Consultancy, we believe in the capacity of orthotics to intervene in the progression of scoliosis and prevent surgery in later life.
For minor curves, usually of less than 20° a patient’s curve will be monitored to ensure it does not worsen while the patient undertakes a tailored Schroth exercise programme which includes some general postural advice to help self- manage the condition.
Typically, for curves of 20-40° we would advise patients to opt for non-surgical treatment through bracing and physiotherapy as it is both non-invasive and painless. We are proud to use what is widely regarded as the most successful brace for treating scoliosis – the Gensingen Brace by Dr Weiss® alongside specialist physiotherapy to correct curves.
Together the process is called the Schroth Best Practice method with LOC being the only centre in the south of England officially recognised by the Schroth Academy.
The brace works by gently and progressively guiding the patient’s spine into a more correct position, whilst being more comfortable and less restrictive than other braces. The brace should be worn for 22 hours a day for the initial 6 weeks of treatment.
After the initial appointment, we take the necessary scans and measurements which are then sent to Dr Weiss himself who assists in the design of each brace which is then manufactured at our Kingston clinic and fitted by one of our specialist clinicians.
Physiotherapy Treatment for scoliosis
There is no ‘one-size fits all’ approach to our Schroth Best Practice physiotherapy as each programme is curve-pattern specific and designed bespoke for each patient. Our physiotherapy package adopts over-corrective techniques to achieve a more normal posture and offload the growing spine. Various exercises are used to strengthen muscles and normalise posture through static, dynamic and stabilising control and by utilising gravity to gain and maintain spinal correction through over-correction. Schroth Therapy is proven to work effectively in reducing curves when used in conjunction with the Gensingen Brace according to Dr Weiss®. Schroth Therapy can also help alleviate pain and improve the appearance of the spine.
LOC’s Schroth Method physiotherapist is Deborah Turnbull BSc CSP with over 10 years’ experience in delivering this method. At LOC, we have successfully treated a large number of patients through the Schroth Best Practice method.
If you would like to book an appointment in our scoliosis clinic, then please get in touch by calling 020 8974 9989 or by using the contact form at the top of this page.