When is Scoliosis Surgery in Children Necessary?

Dear Parents,

The timing of surgery for your child diagnosed with scoliosis is one of the most difficultdecisions to make. As an orthopedist, I understand the anxiety you experience in this process. In the light of my professional experience, I would like to share with you what objective criteria the surgical decision is based on.

My goal is to reduce your concerns and strengthen your communication with your physician by informing you.

Not a Figure Alone: A Holistic Assessment

Families often ask, “How many degrees of surgery are needed?” waiting for an answer to his question with a clear figure. But real life is not that simple. 40-50 degrees Although the range is often the critical threshold at which we are judged in surgery, we do not make our decision by looking at this figure alone. The decision to operate is made by evaluating four basic factors that come together, such as fragments of a dislocation:

Cobb Angle (Degree of Curvature)

• Between 25-45 Degrees: Usually, if the child has growth potential, follow-up with corset therapy and stopping the progression is aimed at stopping it.
• 40-50 Degrees and Above: This threshold is one of the most important indicators for surgery. The risk of progression of curvatures of this degree is very high, especially if the growth of the child continues. With surgery, this progression is stopped and the existing curvature is corrected.
• Above 50 Degrees: Scientific studies show that even in individuals who have reached skeletal maturity, curvatures above 50 degrees can continue to progress by 0.5-1 degrees per year throughout life. Therefore, with curvatures of these degrees, surgery is on the agenda in order to prevent future problems.

Child's Growth Potential (Bone Age and Risser Sign)

This is a factor that can be even more critical than the degree. We ask the question: “How much growth is left in front of the childgrowth?” The more growth, the faster the curvature progress.With bone age and an area of growth in the hip bone Risserișaret We rate it with (usually rated between 0-5). Risser stage 0-1 and a child over 40 years of age is one of the strongest candidates for surgery.

Speed of Curvature Progression

In the process of tracking, in the curvature between the two control graphs Increase of 5 degrees or more Its observation is an important warning sign for us to change the treatment plan. If the curvature progresses rapidly despite corset treatment, surgery should be considered.

Cosmetic Appearance and Quality of Life

Scoliosis is not just an X-ray finding, but a condition that affects the life of the child. If a pronounced back hump (rib hump), shoulder and hip asymmetry affect the child's self-esteem, if he has difficulty wearing clothes and this condition pushes him to social withdrawal, these factors play an important role in the surgical decision.

What Are the Risks of Saying “Let's Wait”?

Sometimes families may want to postpone surgery or turn to alternative methods altogether. This is understandable. However, waiting in a curvature that requires surgery can bring with it the following risks:

• The curvature increases further and the operation becomes technically more difficult.
• Relatively lower correction rate in advanced curvatures.
• Increased sterility of the spine and decreased flexibility.

Instead of a Final Word: A Shared Decision Journey

Remember, the most correct timing for your child is his is specific to his personal situation. With a child of growing age of 45 degrees, rapidly progressing and with pronounced deformity, the surgical decision for a teenager of 55 degrees, who has reached bone maturity and has stopped progressing, may differ.

As physicians, we draw you a roadmap with our scientific data, clinical experience and radiological findings. The final decision, equipped with this information, is a joint decision that must be made with the best interests of your child together with you and the families.

Important Note: This article is not a substitute for an examination and consultation of an orthopedic specialist. For all decisions regarding diagnosis, follow-up and treatment, please contact the doctor who follows your child. Each child is special and his treatment must also be personalized.