Many people with scoliosis who capitulate to scoliosis surgery still end up in chronic or constant pain later in life. This is due to the fact that the scoliosis surgery is essentially a trade-off situation in terms of scoliosis treatment. A human spine has 24 vertebrae (26 if you count the skull and sacrum) that demonstrate independent motion. This independent motion allows us to maintain maximal flexibility throughout our life span. Our ability to maintain a good quality of life long-term depends highly upon these joints staying mobile. It is well known that as soon as any joint is immobilized, within two hours there is microscopic evidence of joint deterioration.
To use an analogy, the spine is like a gear system. In order to turn, bend forward, reach for something, or even walk, each of these 24 vertebrae has to move in order to accomplish said task. As single joints become immobile, whether through joint damage due to trauma or surgical fusion, the remaining mobile joints must compensate and take up that joint's workload, which accelerates the rate at which subsequent joints deteriorate. This is exactly why when people have lumbar fusion surgery for a disc herniation, the next disc above or below nearly always deteriorates at a rapid rate, making repeat surgeries necessary.
In scoliosis surgery there are typically several joints that are fused together, making a spine with 24 moveable vertebrae now a spine with only 12-17 functional vertebrae. This lost range of motion can never be fully made up by the remaining mobile joints. Therefore, the individual usually experiences pain associated with joint deterioration, since joint and disc deterioration causes increased blood and nerve supply to grow into the immobilized joint, making the joint more hypersensitive to pain.
My intention with writing this article is not to browbeat people into avoiding surgery. However, I do think people don't often consider the long-term ramifications of their decision. Having scoliosis surgery for a 100-degree scoliosis is a much different circumstance than selecting it for a 42-degree scoliosis. Of course age and other genetic and environmental factors are at play here. Also, realize that people who have scoliosis surgery still see their scoliosis get worse over time despite the fusions. This is where I believe that scoliosis exercises can have a beneficial impact of the quality of life of post-surgery scoliosis patients.
Several years ago I published a case series in which one of the patients was treated 18 years after having scoliosis surgery. At that time her scoliosis had increased to the point where it was nearly identical to the immediate pre-surgery measurement 18 years earlier. However, by participating in an exercise-based scoliosis therapy, I was able to help her get her scoliosis back down to the initial post-surgery measurement. This made an incredibly positive impact on her pain levels and daily function. Therefore, the point of this article is to tell people that even if they've already had scoliosis surgery, they are not necessarily doomed to their outcome if the outcome was not a positive one long-term. I frequently see these cases in my office around 17-25 years after the scoliosis surgery.
To use an analogy, the spine is like a gear system. In order to turn, bend forward, reach for something, or even walk, each of these 24 vertebrae has to move in order to accomplish said task. As single joints become immobile, whether through joint damage due to trauma or surgical fusion, the remaining mobile joints must compensate and take up that joint's workload, which accelerates the rate at which subsequent joints deteriorate. This is exactly why when people have lumbar fusion surgery for a disc herniation, the next disc above or below nearly always deteriorates at a rapid rate, making repeat surgeries necessary.
In scoliosis surgery there are typically several joints that are fused together, making a spine with 24 moveable vertebrae now a spine with only 12-17 functional vertebrae. This lost range of motion can never be fully made up by the remaining mobile joints. Therefore, the individual usually experiences pain associated with joint deterioration, since joint and disc deterioration causes increased blood and nerve supply to grow into the immobilized joint, making the joint more hypersensitive to pain.
My intention with writing this article is not to browbeat people into avoiding surgery. However, I do think people don't often consider the long-term ramifications of their decision. Having scoliosis surgery for a 100-degree scoliosis is a much different circumstance than selecting it for a 42-degree scoliosis. Of course age and other genetic and environmental factors are at play here. Also, realize that people who have scoliosis surgery still see their scoliosis get worse over time despite the fusions. This is where I believe that scoliosis exercises can have a beneficial impact of the quality of life of post-surgery scoliosis patients.
Several years ago I published a case series in which one of the patients was treated 18 years after having scoliosis surgery. At that time her scoliosis had increased to the point where it was nearly identical to the immediate pre-surgery measurement 18 years earlier. However, by participating in an exercise-based scoliosis therapy, I was able to help her get her scoliosis back down to the initial post-surgery measurement. This made an incredibly positive impact on her pain levels and daily function. Therefore, the point of this article is to tell people that even if they've already had scoliosis surgery, they are not necessarily doomed to their outcome if the outcome was not a positive one long-term. I frequently see these cases in my office around 17-25 years after the scoliosis surgery.
