Bones, Muscles & Joints (Orthopaedics)
1 in 1000 individuals have scoliosis requiring surgical treatment. In 2009 more than 3600 surgeries were performed in the United States for Adolescent Idiopathic Scoliosis (AIS). Experts in scoliosis surgery at Montefiore Medical Center understand and manage scoliotic curves of all magnitudes with excellent clinical outcomes.
It is critical that patients seek a hospital with surgeons who have expertise in scoliosis and are dedicated to correcting all types of spinal deformities. Montefiore has a surgical team specialized in scoliosis surgery.
Genesis of Scoliosis/The First Doctor Visit
There are different types of scoliosis depending on the cause and the age of the patient. While the cause of adolescent idiopathic scoliosis is unknown, doctors attribute genetics and other factors as the basis of spinal deformities. Usually an annual exam performed by a pediatrician or school nurse will reveal the curvature in the back and the patient will need to consult with a doctor specialized in scoliosis treatment.
During the first visit with a scoliosis expert the doctor will perform a detailed physical exam, will obtain spine X-Rays if necessary to confirm the diagnosis and the patient will answer some questions about their health. After this assessment our expert team will decide which treatment method is the most appropriate for each patient including: observation, casting, bracing and in some occasions, surgery.
Non-Surgical Treatment Options
Many cases of scoliosis are mild and require only X-rays and an annual physical examination. Physicians can assess the severity of a curve by looking at the X-ray. Our physicians and radiologists use the most advanced technology for scoliosis testing. If a patient during his or her growth years has a curvature of 10 to 25 degrees, it may be necessary to conduct an examination every four-to-six months. As long as the curve does not increase, further treatment is not necessary.
If the curve is between 20 - 30 degrees, bracing is usually recommended if the child is still growing. While braces do not correct scoliosis, they prevent the curvature from increasing and can avoid the need for surgery when worn compliantly. If the curve is contained to 45 degrees or less at the end of growth, the patient will not need surgery. Curve control success rates with braces are around 70 percent compared to 50 % with observation alone. If the curve advances beyond 45 degrees, surgery is usually indicated.
Distinguished Surgical Expertise
Montefiore and its scoliosis experts are world leaders in the field of spinal deformity surgery and have performed successful Posterior Spinal Fusions for several decades. We use the most advanced surgical techniques to correct scoliosis most of the time from the back through a linear incision with the use of modern pedicle screw instrumentation. During surgery we use cutting edge surgical navigation for screw placement that makes screw placement accuracy close to 100%.