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Should I get Surgery for a 55 degree curve with little pain?

I am a 30 year old male with scoliosis. I was first diagnosed when I was about 16, bracing was not done because they thought I was too old. At 19, my curves measured roughly 45 degrees in both thoracic and lumbar regions. My parent's and I decided not to get the surgery because they said I had finished growing and it would probably not progress. Last year I had another x-ray, and measured 55 degrees thoracic and 45 degrees lumbar. So it seems like my thoracic curve is progressing.

I keep reading that people should not have the surgery unless the scoliosis is causing a lot of pain, but it is honestly not causing me a lot of pain. On an average day my pain is a 3 out of 10, on some bad days it can get up to a 5 or 6 out of 10. It does seem like as I age, I get shorter, and the pain slowly gets worse. On the other hand, I have noticed that doing certain stretches and exercises will reduce my pain. So it seems like my pain is manageable, at least for the moment.

On the other hand, I really hate how disfigured I am. My right shoulder is noticeably higher than my left, and my head is more than an inch off center. I actually decided to always wear a shirt in public now, even at beaches, because I think people will notice how disfigured I am. To be honest, I sort of want the surgery just so my body would finally be symmetrical.

I am getting conflicting advice from websites, they say "only get the surgery if you're in a lot of pain" and also say it's recommended for curves over 50 degrees, even in adulthood.

So I guess I am asking you for advice: should I get the surgery for a 55 curve that appears to be progressing, that is not causing a large amount of pain? Do you think I should wait until it starts causing more pain?
Michael Knapp
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Comments

  • LizLiz Posts: 9,745

    Liz, 

    Veritas-Health Forum Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • I am a 30 year old male with scoliosis. I was first diagnosed when I was about 16, bracing was not done because they thought I was too old. At 19, my curves measured roughly 45 degrees in both thoracic and lumbar regions. My parent's and I decided not to get the surgery because they said I had finished growing and it would probably not progress. Last year I had another x-ray, and measured 55 degrees thoracic and 45 degrees lumbar. So it seems like my thoracic curve is progressing.

    I keep reading that people should not have the surgery unless the scoliosis is causing a lot of pain, but it is honestly not causing me a lot of pain. On an average day my pain is a 3 out of 10, on some bad days it can get up to a 5 or 6 out of 10. It does seem like as I age, I get shorter, and the pain slowly gets worse. On the other hand, I have noticed that doing certain stretches and exercises will reduce my pain. So it seems like my pain is manageable, at least for the moment.

    On the other hand, I really hate how disfigured I am. My right shoulder is noticeably higher than my left, and my head is more than an inch off center. I actually decided to always wear a shirt in public now, even at beaches, because I think people will notice how disfigured I am. To be honest, I sort of want the surgery just so my body would finally be symmetrical.

    I am getting conflicting advice from websites, they say "only get the surgery if you're in a lot of pain" and also say it's recommended for curves over 50 degrees, even in adulthood.

    So I guess I am asking you for advice: should I get the surgery for a 55 curve that appears to be progressing, that is not causing a large amount of pain? Do you think I should wait until it starts causing more pain?
    Michael Knapp
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  • SarahLindeauSarahLindeau Posts: 766
    edited 08/10/2014 - 11:31 AM
    There are always many considerations to discuss when deciding on whether surgery is a good plan. As you mentioned, one of the most common reasons is to fix a structural problem that causes pain. You fit the first clause, but the second part (causes pain) is not as clear a "yes" as you'd like it to be. But the decision to undergo surgery is still very case specific and a tough call to make, even for those of us with a structural anomaly together with pain. Your age, your life situation, your expected outcome, your support system, your job, your insurance, your surgeon, your hospital... The list goes on and on. And until you decide what YOUR desired combination of any of the above is, this is a conversation for you, your doctor and your immediate family.

    I can certainly understand the desire to fix what you feel is a disfigurement. There is a lot of emotional baggage I'm sure you're carrying around. You might find help if you can have a therapist to talk to. If you decide surgery is the way to go, your insurance may require a psychological evaluation to make sure your mindset is ok for the tough road surgery entails.
    2015: Thoracic protrusions C7-T1, T3-4, T6-8
    Dec'13: 360FusionL4-S1 w/bone graft
    2013: 3x2-level disc injections: 12mo surgery postponement
    Dec'12: DiscogramL4-S1
    Sep/Oct'12: Bi-lateral Rhizo AblationsL4- S1
  • Babette123BBabette123 Posts: 7
    edited 08/10/2014 - 10:19 PM
    I was given scoliosis from a doctor. I was not born with it. I had spinal stenosis and wanted a laminectomy. I kept getting no as an answer. Almost 6 yrs. later with nerve pain, I was given an emergency laminectomy surgery, EDIT then I had no choice and had a big scoliosis surgery. 2 rods with hardware from neck to pelvic area. They didn't listen to me and I was in great shape before being opened. Even before the first surgery, where I had nerve pain, I remember some bad days but compared to now, I wish I said no, but all I thought was I was finally getting a laminectomy. Now that's just me and you may get a great doctor and be happy. If you don't have a lot of pain, I would continue asking. I understand feeling self conscience. Hopefully, you'll get a better answer than mine. I wish you the very best.

    Post edited to remove inappropriate comment...Liz spine-health moderator.. Please read the Forum rules
  • If you are unhappy with the extent of the curve, it would be worthwhile consulting with a board certified spine surgeon who specializes in the treatment of adult scoliosis. After examining you and the images, he can go over treatment options with you based on your specfic medical condition.
    Surgery is done to correct an anatomical deformity, and not so much for pain relief so it is worth investigating and asking questions about your treatment options at this stage.
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  • I have had Scoliosis surgery, and I say avoid it if you can. Even though I had the surgery, my curve is still at 47, so almost as high as yours. yes, it's no fun from a cosmetic standpoint. But hey, at least now you can still bend your spine! Scoliosis surgery fuses several levels of your spine in the middle, so you won't be able to ever again bend or arch your back again. If you are already thirty years old, I doubt your curve would get much worse...even so, I know people without surgery who have curves at 67 and higher who are leading normal lives. Having almost your entire spine cut open and fused hurts! And it takes several months, basically a year, to recover. It also feels very uncomfortable to have metal rods and screws in your spine. Do some serious research on this before commiting to surgery.
  • Hi, I agree with Sandi. I was diagnosed with scoliosis at 15 years old, and had the surgery immediately. I wish I had explored other options before deciding on surgery, but, as a minor, I just went along with what my doctor and my parents recommended. My curve before surgery was 40 degrees, and after was reduced to just 9 degrees. However, I had not quite finished growing and by age 19, my curve had progressed to 23 degrees, even with the surgery. I really wish I had continued to have periodic check-ups with a doctor that specializes in scoliosis and other spinal deformities, but I didn't. I have been in pain for quite some time, but I'm not sure if it has to do with the surgery or with the continued worsening of my curve. I will be seeing a specialist next week to have this checked out.
    My advice to you would be to do some research on doctors in your area that specialize in scoliosis and other spinal deformities...not all orthopedic surgeons are fully aware of the uniqueness of scoliosis and the treatment options now available.
    From some of the things I have read about scoliosis and the decision to have the surgery depends partially on if it is affecting the placement of your inner organs (kidneys, lungs, liver, etc). This may be something you will want to discuss with your doctor as you decide which option would be best for you.
    Good luck! I know it is a tough decision! If you have any further questions, feel free to private message me!
  • I keep reading that people should not have the surgery unless the scoliosis is causing a lot of pain, but it is honestly not causing me a lot of pain. On an average day my pain is a 3 out of 10, on some bad days it can get up to a 5 or 6 out of 10. It does seem like as I age, I get shorter, and the pain slowly gets worse. On the other hand, I have noticed that doing certain stretches and exercises will reduce my pain. So it seems like my pain is manageable, at least for the moment.
    emma
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