Surgical Treatment for Scoliosis in Children

Orthopedic surgeons at Hassenfeld Children’s Hospital at NYU Langone specialize in treating children and adolescents with scoliosis who have a pronounced spinal curvature (more than 50 degrees). Surgery is often the most effective treatment when scoliosis cannot be controlled with a brace or physical therapy. Surgery may also be used to treat other spinal abnormalities that may be either the cause or result of scoliosis, such as a spinal cyst or spinal cord compression.

Our surgical team is experienced in performing several different types of spine operations. To achieve the best result, our orthopedic surgeons may work with neurosurgeons and plastic surgeons.

Spinal Fusion

Spinal fusion is the most common type of surgery for scoliosis. During this procedure, surgeons use rods, screws, and small pieces of bone—called bone grafts—to fuse the vertebrae that are causing the curvature and to prevent it from returning. The bone graft is usually taken from the child’s lower spine. At Hassenfeld Children's Hospital, the incision is most often closed using a plastic surgery technique that greatly reduces the risk of infection after surgery.

Spinal fusion is a major operation that takes four to five hours to complete while your child is under general anesthesia. The rods can be left in place permanently, and most children do not require a brace after surgery. The vertebrae usually fuse together completely within three to six months.

Immediately after surgery, your child may remain in the hospital for a few days, until he or she can walk and perform tasks such as dressing and climbing steps. Your child may continue to recuperate at home for three to four weeks, avoiding extreme bending, twisting, stooping, or lifting of heavy objects. He or she can typically return to normal activities within two to three months.

Complications, such as pain and incomplete healing of the vertebrae, are rare with spinal fusion surgery.

Fusionless Surgery

Our orthopedic surgeons also perform several fusionless surgical techniques to treat children ages nine and younger with severe, progressive scoliosis while they are still growing. These techniques use devices such as expandable titanium ribs and flexible growing rods that lengthen as the child grows and help straighten the spine. Children with more pronounced spinal curvature may need spinal fusion surgery around age 13, after their growth slows.

Your child may remain in the hospital for a few days, and recovery may continue at home.

Thoracoplasty

In some children, scoliosis pushes one of the ribs out of position, causing a “rib hump” in the chest. Thoracoplasty is a cosmetic procedure in which the surgeon removes or shortens the protruding rib. A new rib grows back in two to three months into a more typical position. Thoracoplasty can be performed alone or in combination with other spine surgeries.

If thoracoplasty is performed on its own, your child may need to stay in the hospital for up to a week. Your child may resume normal activities within three to four months after the procedure.

After any back surgery, our doctors may prescribe medications and physical and occupational therapy to relieve pain and restore mobility, strength, flexibility, balance, and body awareness, which may change as your child’s spinal alignment improves. Our therapists can also recommend assistive devices and techniques that can help your child to perform everyday tasks, such as getting dressed or reaching for things, until he or she is able to bend more easily.

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