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.
Back bracing does NOT feel the same as the spinal fusion. Back bracing is incredibly stiff and inflexible, whereas a spinal fusion should not leave you feeling similarly. I have had both the Boston brace and a spinal fusion (13 years ago). Yes a spinal fusion will have you feeling a bit more ‘fixed’ at first but in no way is it as horrible as you have made it sound.
I feel as though you have an agenda and write a very biased article towards having people do Pilates with you, without having been through this procedure. I had done pilates for years and now I powerlift without issues.
No problems with my spine and my quality of life is so much better than previously. I don’t get back pain post surgery. I don’t have limitations that you Seem to heavily emphasise (instead of how it can drastically improve someone’s quality of life).
I agree that Pilate may help strengthen and prevent to a degree but for some people, they require surgery. And for a lot of people, it does improve their quality of life. Everybody should prioritise movement, scoliosis or not. Regardless of a fusion, that will always help. And people are not always limited by their surgeries.
You also mention ‘ Another side effect of surgery is an increased risk for vertebral and disc problems in the unfused areas of the spine.’ Does this not happen with the natural ageing process? Can this not happen with people that do all sorts of jobs, activities, and living particular lifestyles separate to scoliosis and or fusions?
I have no doubt you are knowledgeable in Pilates and some preventative treatment, but you seem out of your depth and like you are pushing very hard against surgery without considering it has a lot of benefits. Ive been through it, and I work in a surgical ward where I see a great amount of people improve their lives following their operation.
Erin Myers says
Thanks for your comment. It sounds like you’ve been through a lot and am so grateful to hear that you’re doing so well, and that your quality of life is better for having the surgery. I know a few people who’ve really enjoyed weightlifting post fusion surgery, and it’s great to hear you are one of them. I agree with you that everyone with scoli should prioritize movement, whether or not they’ve had surgery.
Adjacent Segment Disease (ASD) — horrible name, but nonetheless what the medical world has named it — is actually just something people who’ve had a fusion deal with. Degenerative changes happen above and below the fusion more rapidly due to the increase of the mobility and wear and tear of them since the vertebra fused can no longer move. Many of Spiral Spine’s fusion clients have needed to have their fusions extended afterwards because of that, with some being a few years and some being a few decades.
Yes, I am very biased against surgery, but do understand that it is the best choice in some circumstances. We have many, many clients that have had surgery at my studio and my staff and I walk alongside them (and their new and different struggles than those who haven’t had it) and teach them on a regular basis. I actually wrote a huge chapter in my latest book, I Have Scoliosis; Now What?, on just this topic. It could be a standalone book all by itself. In that chapter I show all sides and it actually finishes with some beautiful success stories, and clients giving advice for surgery. I bet you’d enjoy the tone of it more than this blog post.
I’m glad your surgery was such a success in your life.
I have severe lower lumbar scoliosis. I’m in so much pain I can’t function very well. Please, if you can, help me. I have very little in the way of resources and live nowhere near a pilates center. I’m messing around with my tRX but don’t see much help in it. I’m terrified by the reality that this is going to get worse.
Erin Myers says
Thanks for reaching out to Spiral Spine. My staff and I would love to help you. I think we need to start out with a virtual lesson to see what you’re dealing with and then we can make a plan from there. Feel free to contact us and we can set up your first virtual lesson. I look forward to walking along your scoli journey with you. I’m proud of you for finding the courage to reach out.
Im interested in learning about the reformer exercises done without using a machine
Erin Myers says
I’m glad you want to learn about exercises for your scoliosis. While I can’t give you reformer exercises without the machine (since the exercises are done specifically because a machine is present), I have many exercises that can be done without a machine. Here is a link where you can find my online scoliosis videos. I also have many non-machine exercises in my latest book, Analyzing Scoliosis, which can be found here. If you want a custom set of exercises you can do at home without equipment, my staff or I would love to do a virtual lesson with you. Greatjob being proactive about your scoliosis.
Hello, I had two scoliosis surgeries more than 20 years ago. I do a lot of exercises but I feel too limited. This is very frustrating and I wish I could remove the rods of my spine and undo the fusing. I know it sounds crazy but is my dream come true to be able to move more freely. I want to know if this is remotely possible.
Erin Myers says
Thanks for reaching out, and I’m sorry you’re feeling frustration with your body. Some people to have the rods removed from their spine and regain a little bit of spinal mobility, but it another spinal operation and it’s hard to find a surgeon who’s willing to do it. That being said, it is done though. Before you go down that path, I want you to do everything you can to make sure all of your non-fused joints work beautifully first. My staff and I have worked with people all over the world who are in your position–many whom choose to not go under the knife again because their body feels so good. I have a teacher at Spiral Spine who is fused just like you named Allie, and she has a hug client base of fused clients that she’s given freedom too. It’s a beautiful thing to behold. We work both in-studio, and also virtually, so we can help you. You can check out this link for info on virtual lessons and also reach out to us via the contact page of this website. I hope my staff and I can help you find the freedom you’re so desiring. I’m proud of you for reaching out.
Marcie Finn says
I thought bracing doesn’t work on
Mature spines. Tether wasn’t an option
for me. I have had 15 surgeries.
I have Degenerative Flatback syndrome
and chronic pain. Plus nerve damage in
both legs and feet.
Erin Myers says
There are different kinds of back braces, which all have different purposes. For your situation, a soft or hard brace with the purpose of compression and stability–not curvature correction or over-correction which is the case for kids and teens whose spines are still growing–would be what you’re looking for. It sounds like you’ve been on quite the journey, and are still on it. I’d be interested to hear what’s currently going on in your lumbar spine, as I’m assuming that’s where your neuro leg pain is stemming from. What surgeries have you had down there and what hardware do you currently have? What’s your strength/fitness level right now. We have to know where we are if you want to make a plan on where we want to go. I’d also be more than happy to work with you (or have one of my staff members work with you) via a virtual lesson–even if it’s initially just to talk and make a game plan. Coming to one of Spiral Spine’s Scoliosis Intensive workshops might be a great place for us to make a game plan too. I hate seeing people in chronic pain who have scoli–there’s always a way to increase one’s quality of life. Feel free to email us at Spiral Spine here: https://spiralspine.com/contact/ if you want more info on virtual lessons and the workshop.
Amy porteus says
Im curious if you have any science based studies and data to show that Pilates stops scoliosis curvature and if you could share that. There is definitely evidence supporting a strong back and core are good for everyone especially scoliosis patients but this article seems to link Pilates as a treatment option which would imply slowing curvature of the spine.
Erin Myers says
Spiral Spine works on bridging the gap between scoliosis scientific studies and practical movement that people enjoy doing. While I haven’t come across any scientific studies specifically on Pilates and scoliosis, I have prolifically written on scoliosis and movement (citing many, many research studies) and would encourage you to read my writings in other blog posts, books, and even my Pilates workout videos and Spiral Spine’s app—all based on scientific studies. My latest book, Analyzing Scoliosis, has over 50 references cited in it. Most of these movement studies can be applied to multiple movement forms, be that physical therapy, Schroth, yoga, and of course Pilates. My field of specialty just happens to be Pilates, so that is the movement form that I mold all the scoli scientific studies into. My primary goal is to give people a better quality of life. While I’ve been able to reduce my scoli curves (as an adult), and my staff and I have been able to do the same with countless adults and children, people’s curves may or may not decrease, depending on a lot of factors. After being in this industry for about 15 years, I’ve learned that people’s quality of life almost always increases when they learn to find joy in movement—and so many people find joy in Pilates. If you ever want to do research on scoli and Pilates I’d love to be involved!