Scoliosis Surgery - Medically Necessary or Cosmetic?

spinal stenosis

Over 38,000 scoliosis surgery procedures (adult and adolescent patients combine) are performed in the United States every year and there is no medical indication for the highly invasive procedure with poor long-term outcomes and a mortality rate (death) equal to that of swine flu (H1N1 virus) ["fatality rate for swine flu could be anywhere between 0.1%-0.35%" and for scoliosis surgery the "mortality rate was 0.17% and 0.40% for pediatric and adult patients".] The primary and only indication for scoliosis surgery is cosmetic improvement. Which, in all fairness is an important aspect and treatment outcome in scoliosis treatment, however current research suggests it doesn't succeed in the in its attempts to correct the spinal deformity associated with idiopathic scoliosis either.

1. Scoliosis surgery fails to improve cosmetic spinal deformity in scoliosis. First of all, no seems to think about the massive scar the length of the spine that results from this procedure (that will ruin bikini season) and a recently published study on the topic of spinal fusion surgery and cosmetic improvement concluded, "Radiographic and physical measures of deformity do not correlate well with patients' and parents' perceptions of appearance. Patients and parents do not strongly agree on the cosmetic outcome of AIS surgery." (Smith 2006)


2. It does not eliminate pain. Pain is not an indication for scoliosis surgery and many studies find that many patients are actually in more pain 3-5 years post op than pre-op. Don't believe me? Check out what I dub "the most unhappy place on earth" which is the scoliosis surgery revision section of the National Scoliosis Foundation Scoliosis Forum.


3. It does not improve quality of life. When asked if scoliosis surgery benefits the patient researcher Berven stated in the September 2007 SPINE Journal "there are no current, definitive studies that answer the question posed above." Which is odd, because a 17 year post follow-up study found 40% of the post scoliosis surgery patients were legally defined as "severely handicapped".

This is in sharp contrast with the 50 year follow up study of un-treated scoliosis patients who seemed to have an significantly increased quality of life than many of the post fusion patients. Surgery does not improve lung function. A published study in the Journal of bone and joint surgery found

"no remarkable improvement in pulmonary function more than two years after surgery; three patients showed deterioration. The results of tests performed less than two years postoperatively showed no improvement in pulmonary function, irrespective of the types of assessments used." Furthermore, an even more recent study from ModernMedicine.com concluded, "This study supports the previously published theory that any surgical procedure that disrupts the chest wall has a negative impact on pulmonary function,"

It does not necessarily halt curve progression in adults. The average curve progression rate in adults with un-treated idiopathic scoliosis is 1-3 degrees a year. Post scoliosis surgery studies indicate a rate of curve progression in post spine surgery adults at Initial average loss of correction post spinal surgery is 3.2 degrees the first year, 6.5 degrees after two years, and 1.0 degrees every year after that of the course of the patient's life.

I believe Dr. Paul Harrington, known for inventing the scoliosis surgery that implants metal rods in scoliotic spines, stated in 1963, "metal does not cure the disease of scoliosis, which is a condition involving much more than the spinal column". I highly encourage every patient whom is considering any treatment to dig deep into the research available (both pro and con), ask your doctor as many questions as you can think of, and have your x-rays read by at least 2 radiologist (non-surgeons), because they are unbias and the Cobb angle measurement (used to determine the "need" for scoliosis surgery for some reason) has a inter-examiner measurement error of +/-5-10 degrees. Everyone has the right to make a truly informed decision.