A Tough Decision: Surgery or Alternatives
If you are reading this, then it is likely that you, or a loved one, are faced with a difficult decision. On one hand, it is possible that your medical physician is telling you that the only option, depending on the severity of the scoliosis, is either bracing or surgery. These options are to avoid scoliosis from progressing and, in younger patients, to reverse the scoliosis and bring down the curve to ‘normal’.
On the other hand, you have browsed the web and found sites like ours, and would prefer, if you could only have some confirmation of success, to go with a non-surgical approach to scoliosis correction. There is a natural alternative scoliosis treatment.
Having studied scoliosis for over 30 years and, as importantly, having had an orthopedist tell my wife and me that “surgery is the only solution to your daughter’s severe scoliosis”, I feel I am in a uniquely qualified position to rationally discuss these options. Having raised my family on chiropractic care as well as various alternative treatments for different health considerations, my observations are the following:
- First options should always be the least invasive, not the most invasive to the body.
- The body, and it is so in the case of scoliosis, does want to correct this serious disorder, but it needs the proper mechanical force vectors and proprioceptive re-education with which to do it.
Consider the following medical reference with regard to scoliosis surgery:Curr Opin Pediatr 2001 Feb;13(1):36-41 “[Complications] include the syndrome of inappropriate antidiuretic hormone, Pancreatitis, superior mesenteric artery syndrome, ileus, pneumothorax, hemothorax, chylothorax and fat embolism. Urinary tract infections, wound infection and hardware failure are not addressed.” [They were not addressed because they happened so often!] (i.e. hardware failures).
- Surgery is oftentimes considered a success, but that is only insofar as it is completed successfully at the end of the surgery without the patient having significant complications during the procedure. It does not avoid future problems. Unfortunately, these problems arise frequently.
Consider another medical reference to scoliosis surgery: Results of Surgical Treatment of Adults with Idiopathic Scoliosis J Bone Joint Surg AM 1987 Jun;69(5) :667-75 Sponseller, Nachemson et al, “Frequency of pain was not reduced… pulmonary function did not change… 40% had minor complications, 20% had major complications, and… there was 1 death [out of 45 patients]. In view of the high rate of complications the limited gains to be derived from spinal fusion should be assessed and clearly explained to the patient.”
- The surgeon will not give you these statistics. References to his success rate are only referencing the surgical procedure itself and its resulting reduction (at most 50%) of the original Cobb Angle.
However, consider the following medical reference: Spine 2001 Mar 1; 26(5):516-25 “Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years with continued loss of 1.0 degrees per year throughout life.” [So, if a 50 degree Cobb angle is corrected by surgery to 25 degrees, it will return to its pre-operative condition of 50 degrees after roughly twenty years.]
It is wise to do your homework. The first decision to be made is whether or not to have surgery. Once that is made, it will thereafter allow you to take the next step. If surgery is your choice, then it will lead you to inquire about who, what, and where. Long term effects? Try to talk to persons who have had surgery over 10-25 years ago, not two years ago. The initial failures of surgery are not usually apparent till adulthood.
- If you pursue a non-surgical approach, it is important to discuss your personal questions with the doctor involved with the treatment, and to get comprehensive answers, to feel comfortable that the treating doctor has had years of experience in this field and understands all of your needs.
- Finally, make a choice; it is crucial to have complete faith in the final decision. Of course, always be willing to ask questions. The proper choice can mean the difference between a normal healthy life for you or a loved one or a debilitating future.
Remember, the least invasive approach should always be tried first; you can always obtain surgery as a last resort. Do not let doctors scare you into rushing to the operating table due to being told that ‘it may become much worse so we need to operate right away’. There is almost always enough of a window of opportunity to make a rational choice.
Sincerely, Dr. Daniel S. Hersh
Video Of Surgery Patient
The Dangers of Scoliosis Surgery
For many people conventional bracing fails to offer any help with scoliosis, and for these cases surgery is often times recommended. However, the failures of bracing can be followed up with the failures of surgery, and the consequences that follow surgery can be far direr. It is important to take into account the risks when contemplating surgical correction, and non-surgical scoliosis correction can be a beneficial alternative for anybody.
What is Scoliosis Surgery?
Spinal fusion surgery for scoliosis is frequently recommended to those who show no improvements with bracing, and spinal fusion literally fuses the vertebrae together. By fusing the vertebrae together it is believed that overtime the spine will straighten out, and the curvature will be corrected. Spinal fusion surgery can approach the spine from both the front and the back of the body, and when approaching the spine from the back the skin is cut into flaps that expose the vertebrae. After the vertebrae are exposed the surgeon removes any growths or abnormalities that may be contributing to the curvature, and then places rods that are meant to correct the curve. After the rods have been properly placed the skin is sown together, and the rods are left to fuse and heal. Some surgery calls for the spine to be approached from the front, and for this the chest must be opened up. To do this the lungs must be deflated and the rib cage opened, and this presents a number of complications in and of itself. This form of spinal fusion is accompanied by a higher risk of complications and lung dysfunction. After surgery it is believed to take up to three months for fusion to happen, and then up to two years for the fusion to be completed.
The complications of scoliosis surgery are far more frequent then they should be, and one survey taken between 1993 and 2002 showed that 15% of children and 25% of adults experienced complications. These complications range in severity, but they should all be avoided at all costs. The act of fusing the vertebrae together reduces the mobility of the spine, and this cannot be avoided. The spine will lose movement in the area that is fused, and even more disturbing is that the spine stops growing in the fused areas. For many people spinal fusion and the continued growth of the areas that haven’t been fused can cause new curvatures to appear. Spinal fusion surgery also often fails to address the 360 degree nature of scoliosis. For many the rotational factors of scoliosis are more evident and dangerous than the curvature of the spine. These people tend to retain the deformities in their rib cage, and sometimes the rotational factors can be made more apparent to the naked eye. Respiratory dysfunction also frequently occurs. After surgery poor lung function can become immediately evident, and this may require a respiratory therapist or respiratory treatments. Pseudoarthrosis may also occur, and this happens when the fusion fails to heal. This can cause a false joint to develop, and this can cause extreme pain. Disc degeneration is another frequent complication, and the stress on the lower back can cause chronic pain and the discs to deteriorate.
Spinal fusion can also be a stepping stone to further surgery. If infection occurs surgery may be needed to provide relief. The rods used to fuse the spine may also break. This can be painful, and it also leads to surgery to fix the broken rods. When the rods on the spine break they can protrude from the skin, and leave the back looking even more deformed than it initially was.
Perhaps most horrifying – but least likely to happen – is the chance of neurological damage. Anytime you’re addressing the spine, nerve damage is a possibility, and spinal fusion surgery for scoliosis (in the worst case) could lead to paralysis. It may also cause numbness in the legs or muscle weakness.
Non-surgical scoliosis treatments are the best way to address scoliosis. Spinal fusion surgery presents a litany of complications that everybody should avoid. Nobody wants to lose mobility in their back, and most of all nobody wants to experience paralysis, and because of this surgery to correct scoliosis should be avoided at all costs.
“Thoracic hypokyphosis with increasing axial rotational instability is claimed to be a primary factor for the initiation of Idiopathic Scoliosis.” 1
1) Sagittal configuration of the spine in girls with idiopathic scoliosis: progressing rather than initiating factor. Rigo M, Quera-Salvá G, Villagers M. Elena Salvá Spinal Deformities Rehabilitation Institute, Vía Augusta 185, 08021 Barcelona, Spain. Stud Health Technol Inform. 2006;123:90-4
This is further magnified by Winter, who also seems to indicate that the Harrington Rods add to the problem. “The idiopathic cases usually exhibit a flattening of the sagittal curves, which had further deteriorated when the Harrington technique was used.” 3
3) Sagittal plane correction in idiopathic scoliosis. de Jonge T, Dubousset JF, Illés T.
University of Pécs, Faculty of Medicine, Department of Orthopedic Surgery, Pécs, Hungary. Spine. 2002 Apr 1;27(7):761.
Adolescent Idiopathic Scoliosis (AIS) – an indication for surgery? A systematic review of the literature.Weiss HR. Disabil Rehabil. 2008;30(10):799-807. RESULTS: No controlled study, not in the short, mid or long term, searched within the review, has been found to reveal evidence to support the hypothesis that the effects of surgery as a treatment option for AIS is superior to natural history.
Surgical Problems as an Adult
Hello. I am very interested in your program. I am a 45 year old female that had scoliosis spinal surgery when I was 15 years old. I have had severe back and leg pain for a long time, which has interferred with my daily activities very much. I had ‘harrington’ rods implanted. The doctors told me that they can remove the hooks only but there is no guarantee that this will reduce my pain.
Sra Augusto P, Santiago, Chile
From A Parent of Child Who Had Surgery
We have another daughter who developed scoliosis when she was 4 years old and and had the opeation when she was 5 she is now 13 and every 6 months has her rods extended there was an incident last year when her rods snapped and they left her for eight months walking around with snapped rods but she,s fine now we just wish they had done smething for amy but they left her and now she has no self confidense and she hates. The way she is because she thinks nobody will want her looking. The way she does I am so sorry about going on but we think this might be amys only chance tto have something done.
Titanium Rods Rejected in Scoliosis Surgery…More Common Than You Think
I had a surgery in the spine due a severe scoliosis, the first intervention was in 1998, they put in a plate of titanium in my spine to correct it and by the year of 2000 I had a rejection with small fistulas I mean small injuries in the spine.
Is there a remedy to my problem? As they have tried to remove the plate of titanium and it’s been impossible due it’s inlaid in the spine bone.
Will I have to remain with this for all my life or there’s any way out?
19 Year Old Girl Who Had Surgery at Age 14
Dear Doctor Hersh,
My name is Susannah. I had scoliosis surgery in 2007 when I was 14. I’m now almost 19 years old. I went into my doctor about amonth ago and he told me that my spine was continuing to curve even after the surgery and recommended surgery again fusing from my L2 to my L4.
I already have fusion from the top of my spine to my L2. I’m still experiencing pain and it’s incredibly noticeable that I have scoliosis. My hips are off as are my shoulders and it’s very frustrating and makes me extremely self conscious. I was wondering if you could give me a second opinion.
I do have x rays and I attached a picture of one of them if you would like to see it.
Hope to hear from you. Thanks again.
CONCLUSIONS: No evidence has been found in terms of prospective controlled studies to support surgical intervention from the medical point of view. In the light of the unknown long-term effects of surgery and in concluding on the lack of evidence already found that surgery might change the signs and symptoms of scoliosis, a randomized controlled trial is long overdue. Until such a time that such evidence exists , there can be no medical indication for surgery. The indications for surgery are limited for cosmetic reasons in severe cases and only if the patient and the family agree with this.
STOP Scoliosis Progression & Avoid Spinal Fusion Surgery
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