Evolution of scoliosis

5 Things I’ve Learned After Having Spinal fusion Surgery | My Experience One Year Post OP |JamieGray – 2022

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Operation: scoliosis surgery

Surgery is often necessary for non-idiopathic scoliosis and very progressive idiopathic scoliosis with an angulation of more than 50°. Typically, surgery is a last resort in a history of scoliosis when all treatments have failed and the progressive worsening of the deformity becomes either painful or aesthetically disabling. Surgery is the last possible resort, it allows a significant improvement in spinal deviation, an increase in respiratory capacity, better aesthetics and also an improvement in self-esteem. It also allows, in the longer term, to resume normal activity with resumption of sport.
The most common intervention in scoliosis surgery is vertebral arthrodesis, it consists of fusing all the vertebrae responsible for the vertebral deformation, by blocking the joints between the vertebrae. Metal rods will be used to maintain the column until the fusion of the vertebrae in order to improve the deviation. Like all operations, it can present risks even if they are rare: neurological lesion, infection of the operating site. It can also happen that the graft does not take and that it is necessary to operate again.

Prevention

It is not possible to prevent scoliosis. Indeed, it is idiopathic, that is to say that we do not know its origin in the majority of cases. One can, on the other hand, monitor a little more the families where scoliosis is frequent and consult his doctor so that he makes an early diagnosis so that the management is done as soon as possible and is thus optimal.

Evolution of scoliosis

The evolution of scoliosis depends on several factors and in particular on the bone age of the young patient (that is to say on his skeletal maturation which makes it possible to evaluate for how long he will continue to grow) as well as on scoliosis angulation:
Below 20°: there is an 80% chance that it will not get worse, but regular monitoring (approximately every 6 months) is essential.
Between 20 and 30°, all scenarios are possible: at this stage, depending on bone maturity, wearing a corset is generally suggested.
Greater than 30°: the risk of progression is very high, hence the interest of diagnosing scoliosis as soon as possible in order to be able to stop its progression and avoid surgery
In adulthood, if the angulation of the scoliosis is greater than 45°, it continues to evolve by around 0.5 to 1° per year.

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