Scoliosis surgery (overview)

Last revised by Henry Knipe on 24 Aug 2021

Scoliosis surgery is indicated when conservative management has failed.

  • Cobb angle ≥45º (skeletally immature) or ≥40-50º (skeletally mature) 1,2
  • progressive scoliosis deformity
  • spinal functional compromise
  • pain not responsive to non-operative treatment
  • pulmonary function compromise
  • cosmesis 2

There are a number of procedures that can be divided into three main groups 1:

The complication rate for scoliosis surgery is relatively high, highest in adult scoliosis (~30%) and in pediatric scoliosis, neuromuscular scoliosis (~17.5%) followed by idiopathic (~8.5%) and congenital scoliosis (~3%) 3. Aside from complications of major surgery (i.e. death, hemorrhage, infection, etc), complications specific to scoliosis surgery include 3:

  • neurological damage, e.g. quadriplegia, paraplegia, nerve damage
  • hardware-related, e.g. misplacement, failure, migration
  • pseudarthrosis
  • curve progression
  • flat back syndrome

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