Scoliosis Surgery

Scoliosis Surgery Overview

Scoliosis surgery is as varied as the types of scoliosis that present to the office. Scoliosis by definition is a curve in the front to back plane of greater than 10 degrees. Of course, a 10 degree scoliosis by itself does not need surgery. For terms of this topic, there are two types of scoliosis that need surgery, idiopathic and degenerative. The idiopathic type is normally found in adolescent children and is normally painless.

There are certain curves (by location and degree of curve) that are known to progress. The surgery is necessary to prevent the expected progression of the curve. In addition, the scoliosis deformity of the spine can cause eventual deformity of the “normal” spine above and below the deformity which is another reason to fix the curve.

The necessity for scoliosis surgery in adults is normally due to degenerative spinal pain and from a breakdown of vertebral segments causing any of the conditions found in surgery section under the lumbar spine (degenerative spondylolysthesis, foramenal collapse and many others).

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(Please keep reading below for more information on this treatment.)

The scoliosis surgery is designed to take a deformed spine, straighten it somewhat and fix it so that the spinal curve will not progress. Essentially, in kids, the deformed but movable spine is traded for a straightened but stiff spine. In adults, the spine is normally stiff and cannot be straightened as much. Flexibility is lost with aging and the vertebra themselves will deform over time.

The straightening is performed with screws that are placed into each vertebra, removal of the facets which loosens the spine and finally two rods which, when attached to the screws, allows for a repositioning of the spine. The rods and screws hold the spine in the appropriate position while the fusion takes place. In most cases, after about 8-12 months the fusion is complete. There is no need normally to remove the instrumentation.

Scoliosis surgery for adults is normally more complex than children as the spine is more degenerative, deformed and will not straighten as well. The complexity is that taking the deformed spine and straightening it can stretch a nerve root and create new nerve pain as some nerves will be tethered and not stretch to accommodate the newly straightened spine. This pain typically resolves after 2-3 months but occasionally can last longer.

To learn more about scoliosis surgery , please contact Dr. Donald Corenman, spine surgeon and back specialist offering diagnostic and surgical second opinions to patients in the USA and around the world.

Related Content

(Click to Enlarge Image) This is an AP X-ray (scoliogram) of a patient with severe scoliosis. The white line depicts the center of gravity line from the head. It should intersect the center of the pelvis. The black horizontal line demonstrates how far off the patients balance is. The amount of energy expended necessary to walk made her use a walker for balance.

(Click to Enlarge Image) This is a post-operative X-ray of the results of a scoliosis surgery. Here you can see that the black line is the new center of gravity line for this patient. She is balanced and can walk without aids. The rods and screws seen are a temporary scaffolding to hold the patient in line while the fusion takes place. After solid fusion, the metal is superfluous.

(Click to Enlarge Image) This is an x-ray of a patient with Scheuermann’s disease.

(Click to Enlarge Image) This is a post-operative x-ray of the surgery necessary to correct the Scheuermann’s disease curve.

Donald Corenman, MD, DC

Average rating:

81 reviews

Eric S

Sep 26, 2021

by Eric S on Donald Corenman, MD, DC

Successful pars repair at 46 years old

Back in November of 2018 (at 46 years old) I came from Vancouver BC to have a pars repair done with Dr. Donald Corenman at the Steadman Clinic in Vail Colorado. I'm finally posting this review nearly three years later in late 2021. The reason I waited so long was I wanted to know the final result before I posted my review. Unfortunately in that time Dr. Corenman has retired. Nevertheless, I want to post this review of Dr. Corenman and his staff at the Steadman Clinic in their excellent treatment of my L5 pars interarticularis.

I fractured my pars at age 42 back in 2014 when rolling on the gym floor, and was denied treatment by the Canadian healthcare system, probably due to my age. First my GP told me there was no surgical option for a pars defect, which was quite incorrect! I tried to live with it, but the symptoms worsened (periodic random spine slippage and weeks of resultant pain after just bending over to tie my shoe, so I eventually learned to mostly squat and hardly bend). When I finally consulted with Canadian spine surgeons, I was told they believed my pars defect had been congenital (since birth). This was absurd, considering I had done extreme martial arts (including jiu jitsu) for years prior, as well as 5 years of reinforcing steel full time in my 20s, probably the hardest job on the back you can find. No pars defect like mine would possibly have allowed this--ergo it was impossible that I had had the defect since birth. I did however have an asymptomatic congenital spina bifida occulta that made me more susceptible to a pars fracture. In 2014 in one instant, I went from having the strongest back people I knew said they'd ever seen, to being unable to safely bend over and tie my shoe without a non-negligible risk of my spine slipping randomly (which would lead to weeks of pain after each occurrence). This was due to the unilateral L5 pars defect, otherwise known as spondylolysis. It was when lying in pain on the floor 4 years later after maybe the 6th spine slippage event post injury, that I had had enough, and resolved to have surgery. If Canada's "universal health care" said no, I would make lemonade from lemons, and find the very best surgeon in the world at pars repairs. That was Dr. Donald Corenman. Dr. Corenman back in 2018 ran a website https://neckandback.com/ that dedicated many pages to the science of every aspect of pars repairs, from eligibility (good discs on MRI), to best surgical techniques (minimal open compared to minimally invasive), best imaging to use (i.e., O-Arm with Stealth imaging vs. older fluoroscopy), the ideal amount of BMP to use and why not use too much or too little, and much more, all to do with pars repairs, pages upon pages of his site just on the pars, with scientific references and his own extensive expert opinion. As a health research statistician, I was very impressed with this. It was in stark contrast to the websites of other spine surgeons which barely gave the pars a word or two, focusing almost exclusively on fusions. I had found the best surgeon in the world for pars repairs, and so after Dr. Corenman personally screened my MRI to ensure my discs were healthy, I booked the surgery.

Being 46 years old at the time of surgery in 2018, with a 4-year-old pars fracture from 2014 combined with a congenital SBO meant my pars fragment was somewhat atrophied, but it was "very solid", said Dr. Corenman in the operative report. Nevertheless, it was challenging with two things to fix, the pars and SBO, and OR time was around 4 hours. Recovery over the following months was guided by a very clear "Spine binder" from the Steadman Clinic with strict rules of "no BLT" (no bending, lifting or twisting), and illustrated physiotherapy guidelines. They even warned patients to avoid fish oil supplements, which could excessively dampen inflammation and hence slow bone healing. They answered many questions I had during months of recovery, with responses coming from the very supportive Lori Fugate (then director of Dr. Corenman's practice), and Ehrich Bean (then physician's assistant at the practice), as well as a couple calls with Dr. Corenman himself after two of the CT scans. Ehrich Bean offered great advice for taking the spine binder conservatively due to the nature of pars repairs vs. fusions. The final post-op CT scan I had was a couple weeks ago at 34 months post-op, and Dr. Corenman had retired, but I got a very positive and informative call from Eric Strauch (current PA at the Steadman Clinic under Dr. Corenman's replacement there, and who had also worked with Dr. Corenman previously). The staff at the Steadman Clinic were extremely supportive all the way through the process. I should mention, the local Canadian spine surgeon did offer me very good post-operative support including antibiotics as needed to deal with a mild surface incision-site infection early on, booking numerous x-rays when I felt something was amiss, as well as booking all four of my post-op CT scans. I am very grateful for that support also.

My final result shows plenty of solid bone across the pars and a healed SBO, with my vertebral body now a solid bone ring instead of being broken at two places as it was pre-op. Does my spine hold up in the real world? You bet! I have recently dug and moved several yards of dirt and sand and gravel by myself (shovel and wheelbarrow!) to fix our water main, pulled roots from the yard, moved several "portable" (these are HUGE) air conditioners up several flights of stairs my myself, and lifted weights. I now run 2 miles (3.2 KM) several times weekly with a hard 100 meter dash in the middle. I bend deeply before each run I go on, with no spine slippage. My spine feels amazing. I can bend over to do exercise, or real word tasks, with no risk of spine slippage.

My sincere thanks to God, Dr. Donald Corenman, Lori Fugate, Ehrich Bean, Eric Strauch, and the Steadman Clinic, as well as the Canadian spine surgeon who offered me excellent post-operative care back in Canada. You have all given me a new lease on life.

Sincerely,
Eric S

Robert S

May 11, 2021

by Robert S on Donald Corenman, MD, DC

Back Fusion Surgery

I had my entire lumbar spine fused in November of 2018. I had scoliosis , with pinched nerves that were so painful I could hardly walk - and standing for more than a few minutes was impossible. Even sitting was painful.
The fusion surgery produced immediate relief! And the recovery was much easier than I expected.
To this day I can do all the activities I love from hiking, to standing in a stream fly fishing to riding my bike long distances - or just walking down the street with my wife.
Kudos to Dr. Corenman and his staff, (including the two Erics) for taking such good care of me!

Leslie R

Jul 9, 2020

by Leslie R on Donald Corenman, MD, DC

TLIF

I had my TLIF surgery on 6/24/2020 by Dr. Corenman, I can not say enough good things about the Dr or his staff. I was always treated with respect and explained everything throughly, that made it easy for everyone to understand. I highly recommend Dr. Corenman and the Steadman Clinic.

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