Scoliosis Bracing & Surgery Facts in Rogers AR

back pain

Bracing

Bracing is the current method of treatment once the cobb angle has reached 25-40 degrees. The objective for bracing is to prevent further progression. There is no documentation to indicate that hard bracing will improve or reduce the progression of a scoliosis. Below is documentation on the effectiveness of bracing and scoliosis.

The etiology of idiopathic scoliosis
American Journal of Orthopedics 2002 Jul; 31(7): p387-395

Results: 50% of the patients surveyed felt that bracing had handicapped their life, and 14% felt it had left a psychological scar.

Adolescent Idiopathic Scoliosis: the effect of brace treatment on the incidence of surgery
Goldberg MD, Moore D.P., et al
Spine 2001 Jan 1; 26(1):p42-7

The children’s research center In Dublin, Ireland has not recommended bracing as a treatment for scoliosis since 1991, stating, “If bracing does not reduce the proportion of children with Adolescent Idiopathic Scoliosis who require surgery for cosmetic improvement of their deformity, it cannot be said to provide a meaningful advantage to the patient or the community.

Surgical Rates After Observation and Bracing for Adolescent Idiopathic Scoliosis: An Evidence-Based Review
Dolan, Lori A. PhD; Weinstein, Stuart L. MD
Spine: 1 September 2007 - Volume 32 - Issue 19 - pp S91-S100

Objectives. To develop a pooled estimate of the prevalence of surgery after observation and after brace treatment in patients with adolescent idiopathic scoliosis

Conclusion. Comparing the pooled rates for these two interventions shows no clear advantage of either approach. Based on the evidence presented here, one cannot recommend one approach over the other to prevent the need for surgery in AIS. This recommendation carries a grade of D, indicating that the use of bracing relative to observation is supported by troublingly inconsistent or inconclusive studies of any level.


Surgery

When a scoliosis progresses to 45-50 and beyond, spinal surgery is the common recommendation amongst medical doctors. Scoliosis surgery is usually effective on a short-term basis. However, life time follow-ups are typically required and show little sustained improvement. In some cases the surgery will require follow-up surgeries due to hardware failure.

Surgery by the Numbers

  • Of the total number of spinal surgeries performed in the United States each year, Scoliosis Spinal surgeries make up roughly 33%.
  • The average cost of a scoliosis spinal surgery is $120,000 per operation.
  • Each year 20,000 patients undergo Harrington Rod Surgery (or similar scoliosis spinal operation).

Expert Opinions

"[Complications] include the syndrome of inappropriate antidiuretic hormone, pancreatitis, superior mesenteric artery syndrome, ileus, pneumothorax, hemothorax, chylothorax and fat embolism. Urinary tract infections, wound infection and hardware failure are not addressed." [They were not addressed because happened so often!]

Medical Complications in scoliosis surgery
Curr Opin Pediatr 2001 Feb;13(1):36-41

"Frequency of pain was not reduced… pulmonary function did not change… 40% had minor complications, 20% had major complications, and… there was 1 death [out of 45 patients]. In view of the high rate of complications, the limited gains to be derived from spinal fusion should be assessed and clearly explained to the patient."

Results of Surgical Treatment of Adults with Idiopathic Scoliosis
Sponseller, Nachemson et al

Conclusion:"Corrosion was seen on many of the rod junctions (66.2%) after long-term implantation."

Corrosion of spinal implants retrieved from patients with scoliosis
Akazawa T, Minami S, Takahashi K, Kotani T, Hanawa T, Moriya H.
Department of Orthopedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chiba, 260-8670, Japan. J Orthop Sci. 2005;10(2):200-5.

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Rogers, AR 72756
(479) 899-6658

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4608 West Walnut Street Suite A
Rogers, AR 72756
(479) 899-6658

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