Scoliosis: Questions/Answers

How is scoliosis detected?
Most curves are initially detected on school scoliosis screening exams, by a child's pediatrician or family doctor, or by a parent when summer swimsuit season (bathing suit time) starts. The diagnosis of scoliosis and the determination of the type of curve is then made by a careful orthopaedic exam and an X-ray to evaluate the magnitude of the curve. The most common type of scoliosis begins in late childhood or early adolescence. It is at this time when the majority of curves are detected.

How can scoliosis be treated?
Small curvatures of the spine do not typically require immediate treatment but do need close observation to monitor for progression of the curvature. For those cases that require treatment, a back brace may be prescribed to attempt to stop the progression of the curvature. The brace is usually worn until the adolescent has stopped growing. If despite wearing a brace, the curvature progresses beyond a certain point, surgery becomes necessary. Only about 10 percent of those with scoliosis eventually require surgical treatment.

What are treatment options if surgery is required?
Surgery for scoliosis involves straightening a portion of the spine and fusing that curved portion. Usually, stainless steel or titanium rods are affixed to the bone with hooks or screws which then maintain the correction until fusion occurs. Surgery may be done from the front of the spine or from the back of the spine or both, depending on the type and location of the curve.

Can scoliosis be corrected with minimally invasive surgery?
At The Cleveland Clinic, scoliosis surgeons are now using minimally invasive surgical techniques to be used in conjunction with or to replace more conventional surgical techniques to correct deformities caused by scoliosis. Whereas conventional scoliosis surgery requires a larger incision, minimally invasive surgery uses a thin telescope like instrument known as an endoscope, which is inserted into the abdominal or chest cavity through small incisions. The endoscope is connected to a small video camera which projects an "inside" view of the patient's body onto television monitors in the operating room. Special surgical instruments may then be passed through one or more additional half inch incisions to perform the required surgery.

What are the benefits of minimally invasive techniques?
Patients undergoing scoliosis surgery using minimally invasive surgical techniques may realize such benefits as reduced postoperative pain, shorter hospital stays, a quicker return to school and to activities enjoyed before surgery, and less visible scarring. Minimally invasive surgery to treat scoliosis is not applicable in all cases. Ask your Cleveland Clinic scoliosis surgeon which type of surgery is best for you.

Normally, the spinal column grows in a straight line from the neck to the tailbone. But for some two to three percent of the population, the spine begins to curve, a condition called scoliosis. If scoliosis is left untreated, the curve can progress eventually causing pain, significant cosmetic deformity and heart, lung or gastrointestinal problems. Most cases of scoliosis can be managed without surgery. For those cases when surgery is necessary, orthopaedic surgeons at The Cleveland Clinic are experts in surgical management and are among the first in the country to make use of minimally invasive surgical techniques to correct the curvature.

This information is for educational purposes only and should not be relied upon as medical advice. It has not been designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.