Minimally Invasive Spine Surgery for Scoliosis: Is It Right for Me?
Question: I’m 59, and last week my doctor told me that I’ll most likely need spine surgery to treat scoliosis. I was first diagnosed with scoliosis in my late teens, but the curve in my thoracic spine has progressively gotten worse (it’s currently 60°). My symptoms have gotten worse, too. I have constant, severe back pain, and you can really notice the deformity now—my right shoulder is significantly higher than my left shoulder. I’m concerned about all the risks of open spine surgery. I know that minimally invasive spine surgery is less risky, but how do I know if it’s right for me?
─Franklin Lakes, NJ
Answer: All types of surgery have risks, regardless if it’s minimally invasive spine surgery (MISS) or open spine surgery. To help you make your decision about what type of surgery to have—and whether you should have surgery—to treat your scoliosis, there are a few things you need to consider.
For your deformity to get better, you’ll need some form of surgery because a spinal deformity doesn’t go away on its own (or even with non-surgical treatments). It’s something you need to treat with surgery, which fortunately, usually can help correct it.
If pain is a bigger concern than the deformity, you can try non-surgical treatment options. In fact, before you make the leap to have surgery, I suggest you try non-surgical treatments for 3 to 6 months (if you haven’t already). Physical therapy, exercise, massage, and acupuncture are examples of non-surgical treatments you can try to treat your constant, severe back pain associated with scoliosis.
If you’ve tried non-surgical treatments for 6 months and you still have back pain and other symptoms, you may want to seriously consider spine surgery.
Whether you have traditional open spine surgery or minimally invasive spine surgery for scoliosis will depend on various factors.
For example, if you have osteoporosis (a disease that weakens your bones), MISS may not be a good choice for you. That’s because MISS spine surgery uses techniques that may not work as well when you have weakened bones.
On the other hand, if you’re in overall good health with mild osteopenia, you may be an excellent candidate for MISS.
In recommending surgery, your spine surgeon will also consider how rigid (ie, stiff and/or inflexible) your curve is. You mentioned that you have a 60° curve in your thoracic spine—that’s a large curve, and your spine surgeon will have to carefully look at the pros and cons of spine surgery in your case.
If he or she gives you the clear for spine surgery, then you should be aware that there are several types of MISS techniques (eg, spinal instrumentation and hardware)—which techniques you have will depend on several factors. You may actually need a combination of these techniques to effectively treat your pain and deformity caused by scoliosis.
But don’t worry, your spine surgeon will walk you through which MISS techniques he or she suggests. Don’t hestitate to ask as many questions as you’d like.
My final piece of advice is to work with a spine surgeon who has a lot of experience with minimally invasive spine surgery, particularly MISS for scoliosis. You may even want to get a second opinion from a surgeon who is competent with both open and minimally invasive techniques to be sure that you are making the right decision to treat your scoliosis.