Surgery is indicated when:
- The deformity is progressive beyond severe angle (e.g. 70 degrees for Scheuermann's Disease) or sagittal balance is significantly abnorma
- Neurologic symptoms exist
- When persistent pain cannot be alleviated using conservative treatment In addition, adolescents with significant deformity, who may not respond to conservative therapy (e.g. bracing) and adults with curve progression and/or chronic back pain, may be accorded surgery.
Spinal instrumentation and fusion are surgical procedures that may be used to correct spinal deformity and to provide permanent stability to the spinal column. These procedures join and solidify the level where a spinal element has been damaged or removed (e.g. intervertebral disc). Instrumentation uses medically designed hardware such as rods, bars, wires, and screws. These devices hold the spine straight during fusion.
Fusion is the adhesive process joining bony spinal elements. In severe cases, spinal fusion is performed both anteriorly (from the front) through thoracotomy (entering chest cavity) and posteriorly (from behind) using instrumentation.