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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 are natural alternative scoliosis treatments options as well.
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 in the scoliosis alternative treatment procedure, 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

Why choose alternative treatments for scoliosis?

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.


Avoiding surgical complications with scoliosis alternative treatments

The complications of scoliosis surgery are far more frequent than 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 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 and the unfused areas become hyperactive causing other health problems.
Spinal fusion surgery also often fails to address the 3-dimensional 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, and early arthritis are commonplace due to the spine’s inability to bend and flex leading to additional complications, and the stress on the lower back can cause chronic pain and the discs to deteriorate much more rapidly than via natural aging.
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 L 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. In case of alternative treatments for scoliosis, the patients do not have to deal with such complications.
Let’s take the recent case of a teenage boy we treated. We’ll call him Michael (not his real name). He was against any form of non-surgical therapy that we presented to him. His attitude to begin with was that “I just want this to be over with”. He did not truly participate in our multi prong therapy program and simply went through the motions. He convinced his mother that the only treatment he was willing to do was spinal surgery because that would get it ‘over with’ right away. 
Here are actual comments from his mother and family:
Sept 13: Praying for his speedy recovery!! He is young and strong he will recover from this!
Sept 15: Update: NO SLEEP HERE!! THIS IS BRUTAL. ON A COCKTAIL OF SERIOUS MEDS AND MORPHINE. HE IS STILL IN PAIN.. A couple of barf bags used up. Docs all passed by. HE STARTS PT WALKING AT 11 & 2 PM. HES EXHAUSTED. SO AM Sept 22: Fantastic progress! The 1st week is the toughest but he is going to be much happier in the long run with no more chronic pain and discomfort.
Sept 29: UPDATE: Tomorrow he will be taken off all IVs and Catheters. He will be walking a lil longer and he will try stairs. The plan is for him to be released tomorrow if all goes well. Then on to the next phase!! He is experiencing a lot of pain. They just gave him oxycodone. He should be in dream land soon. THANK U FOR ALL UR BEAUTIFUL WORDS!! I HAVE READ THEM ALL TO HIM.
Oct 6: Waiting for discharge papers!!! Bye bye hospital... we ain't gonna miss ya!!I’m glad he’s going home and I hope his pain is getting more manageable, Not's still very bad. But he's young... that's an advantage
Oct 23: How did school go ?Very painful. Those chairs have no head rest or support. He makes it three half the day. And then he calls me to pick him up. He still has another 2 months of pain to go. I can't wait for the day he tells me he has no more pain
Nov 11:Not sure Debbie... JUST BEING HONEST... ACADEMICALLY: he's trying to keep up with school while making up missed work. PHYSICALLY: he's in so much pain, he tries to stay in school as long as he can and then calls me in tears to pick him up because the chairs in class hurt his back so much. MENTALLY: I think he's not doing well. He doesn't smile and he's just so exhausted of being in pain. HE JUST WANTS THIS TO BE OVER. ALL I DO IS PRAY AND SHOW HIM LOTS OF LOVE. Breaks my heart everyday. But God has a purpose for this...I HAVE FAITHOh no ….. This is so stressful and painful in many ways for Michael and everyone.

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 alternative treatments for scoliosis are the best way to address any condition. 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; 123:90-42) This is further magnified during 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.” 33) 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.



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