New clients often ask what my thoughts are on scoliosis spinal fusion surgery and its side effects, because that is the only option they were given by their doctors to treat their scoliosis. I’m going to have the conversation I have with them with you. To summarize:
- Doctors usually don’t mention treatments besides bracing and surgery.
- Pilates (and other movement) are great non-surgical options.
- If you have scoliosis spinal fusion surgery, a major side effect will be physical limitations. Make sure you know how your body will be limited before you have the surgery.
- Another side effect of surgery is an increased risk for spinal problems in the non-fused part of your spine for years after surgery.
- If you have surgery, movement afterwards will be key to your healing.
First off, please know that you always have options besides surgery. Just because your doctor, who most likely is a surgeon, doesn’t give you any other choices or may even audaciously tell you that there are no other options—doesn’t mean that there aren’t other treatments. Again, there are always other options.
I HIGHLY recommend you exhaust all other forms of conservative therapy before having surgery. One choice is regular movement, and I have researched and written extensively on this topic throughout the years. You can read a few blogs about it here and here and check out my latest book devoted to movement, Analyzing Scoliosis. Personally, I find Pilates to be the best form of movement for my scoliotic body and many of my clients’ bodies, but many types of movement can be beneficial. Unfortunately, spinal fusion surgery takes away a lot of your ability to move.
Another non-surgical option to investigate is back bracing. Have you ever worn a back brace that immobilizes your spine for 18+ hours a day? It’s a bit like what having a fused spine is like, except the fusion is permanent and the brace is not. Before you schedule surgery make sure you know, without a shadow of a doubt, that it’s the right choice for your body, because once you have a fusion there’s no going back.
That being said, lots of people around the world are fused every year, so if you make the choice to be fused, it’s very important to be well-informed about the surgery and make wise choices in regards to it. Not all surgeons are the same and not all scoliosis surgeries are the same.
At my Pilates studio, one of my amazing teachers, Allie, has a fusion that pretty much goes the entire length of her back. She went through surgery when she was only 14 years old, as many people who receive a fusion for scoliosis do. These days she teaches many of the Spiral Spine Pilates Studio clients who have been fused and they benefit so much from her lessons.
Every few months Allie shares her immense frustration with me on how ill-informed the fusion community is. Most people have no idea that scoliosis is not “taken out” just because they had surgery. They still have the same rotational patterns and lateral bending post surgery, though it is most likely decreased. They have simply traded a mobile, twisted spine for a non-mobile, sort of straight spine. Also, most times their scoliosis pain doesn’t decrease.
Amazingly, most people don’t understand that the part of the spine where hardware is implanted never gets to move again. Depending on what hardware is implanted and where it’s placed, you’ll never again be able to round your back forward, backwards, sideways, or twist.
When people are fused, they typically come to see me six to twelve months afterwards. They come to my studio for their first lesson because their body is still in so much pain, and their doctor suggested they try Pilates. Why their doctor suggested they try Pilates post-surgery instead or pre-surgery always baffles me. It always hurts my soul when one of my teachers or I have to inform a teenager and their parent post-surgery that the teenager will never be able to move their back again. Having to deliver that information always sits heavily with me. I will never understand why this conversation wasn’t had by their doctor prior to the surgery.
Another side effect of surgery is an increased risk for vertebral and disc problems in the unfused areas of the spine. The vertebrae and discs above and below where the surgical hardware are implanted will always be at a high risk of degenerating, collapsing, and herniating. If that happens, another surgery to extend the fusion is most likely in your future.
And since scoliosis isn’t really ever removed from the body, I’ve seen all too often that the scoliosis will show itself in the unfused vertebrae above and below the fusion, twisting and rotating them as well. This happens years post-surgery, despite the spine initially being fairly straight right after surgery. If you don’t want this to happen, proper core work and biomechanics need to be done.
If you do decide to have a fusion, you will still have to care for your body. You’ll need to keep it strong, especially your core, in order to prevent you from living in pain. You will need to keep it moving to prevent all your muscles from becoming overly tight and causing further pain. Pilates is one of the main types of movement that can help you achieve this.
If you choose to never have surgery, are planning on having surgery soon, or have already been fused, please know that you need to move wisely for the rest of your life to properly care for your scoliosis. Spiral Spine Scoliosis Resources and Spiral Spine Pilates Studio can give you the tools to help you live a fabulous life while living with scoli.
Remember, no matter where you are in your journey, it’s your responsibility to educate yourself on your individual scoliosis and your treatment options. You owe it to yourself to try different movement therapies before making an irreversible decision that will affect you for the rest of your life.
If you’re looking for more guidance, I suggest the following:
- Resource lists for people with scoliosis who are fused and unfused
- Scoliosis Intensive — a unique two-day workshop where you’ll leave with a deep understanding of your scoliosis, a home routine, and leads on creating your own movement dream team in your hometown
Have any of you had surgery? Have any of you decided against surgery? Drop your story in the comments.