Scoliosis of the spine can occur in adolescence as well as adulthood. The majority of patients who develop scoliosis in adult do so as a byproduct of degeneration of the spinal discs and joints. This degeneration may lead to back pain, nerve compression with associated leg pain and difficulty with walking. When conservative measures, such as physical therapy with core strengthening, spinal injections and bracing fail, surgical correction of this condition can help patients return to a more functional and less painful life.
Surgical treatment is reserved for a small subset of patients who have failed all reasonable conservative (non-operative) measures. They generally have disabling back and/or leg pain and spinal imbalance. Their functional activities are severely restricted and their overall quality of life has reduced substantially.
The goals of surgery are to restore spinal balance and reduce pain and discomfort by relieving pressure off the nerves (decompression) and maintaining corrected alignment by fusing and stabilizing the spinal segments.
The complication rate can be significant higher and the recovery, slow. Therefore, surgery should only be undertaken as a last resort and only after the patient has a clear understanding of the risks and benefits. At the same time, when patients are carefully chosen and are mentally well-prepared for the surgery, excellent functional outcomes can be obtained which at times can be a positive life changing experience for a given individual patient. Recent advances in surgical techniques include less invasive approaches by making smaller incisions as well as using biologic substances to accelerate the fusion process.