Scoliosis & Spinal Deformity

Our spine specialists first consider nonsurgical treatment for scoliosis and spinal deformities. Surgical correction is recommended when non-surgical approaches are not effective.

Treatment without surgery: Schroth physical therapy

People with mild to moderate spinal curvature may benefit from Schroth physical therapy. The goal of the Schroth method for scoliosis is to optimize the health of each patient's spine and movement system throughout the lifespan. 

Through specific exercises and corrective breathing techniques, the therapist aims to elongate your trunk and correct imbalances in the body. By developing the inner muscles of the rib cage, this therapy changes the shape of the upper trunk to correct spinal abnormalities. 

The result is a decrease in pain, slowing or halting of the curve's progression, and better heart and lung function, mobility, and posture. Many adolescents with idiopathic scoliosis benefit from starting treatment with Schroth physical therapy.

Scoliosis and other spinal deformity surgeries

Scoliosis surgery, or surgery such as kyphosis treatment or lordosis treatment, may be needed if your curve worsens. If you are having trouble with breathing, digestion, or heart function, you may need surgery to reduce the impact of the spinal curve on your organs. The procedure used depends on your age and the type and severity of your spinal deformity. 

Anterior vertebral body tether (AVBT) is a newer approach for idiopathic scoliosis. A flexible cord is placed from the front part of the spine only along the convexity of the curve. This allows for correction of scoliosis and continued growth on the opposite (concave) untethered side of the curve in children who are still growing.

Growing rods can be inserted to correct scoliosis in children without fusing the spine, minimizing any stunting of growth that can occur with spinal fusion. We most often use these types of growing rods:

• Traditional growing rods are anchored at the top and bottom of the spine and periodically lengthened in a simple procedure as the child grows.
• Vertical expandable prosthetic titanium rib (VEPTR) is attached to the ribs at the top of the device and the spine or hips at the bottom. It is helpful for infants and children with scoliosis and breathing problems.
• MAGEC® Growing Rods. NewYork-Presbyterian was the first hospital in New York City to offer MAGEC (MAGnetic Expansion Control) growing rods. MAGEC treatment involves the surgical placement of special growing rods in a young child's spine. The surgeon adjusts the rods every few months afterward using a remote-controlled device applied to the outside of the child's back during a routine outpatient visit, sparing the need for repeated surgeries.

Spinal fusion is most often a treatment for scoliosis in adults whose spines are no longer growing. The vertebrae are fused with bone grafts, metal rods, and screws attached to the spine to correct the curve during this procedure. For people with severe curvature, this can be a complex process that also requires physical therapy before the operation to maximize your condition and afterward to support your recovery. The team at Och Spine includes all of the doctors, nurses, and physical therapists you need to optimize your outcome. 

Treatment of vertebral compression fractures. People with spinal deformities who have compression fractures may benefit from interventional treatments. 

During vertebroplasty, the surgeon injects artificial bone cement into a fractured vertebra. The cement stabilizes the bone and prevents further damage from occurring. With another treatment—balloon kyphoplasty—a tiny balloon is inflated inside the fractured vertebra to restore its height. The cement is then injected into the expanded space to ensure the bone does not collapse again. 

Both procedures are performed under X-ray guidance. Vertebroplasty and kyphoplasty may be recommended as part of kyphosis treatment or lordosis treatment when fractures are present.

Microdiscectomy. This operation may be performed in people whose spinal deformity is causing disc problems that are placing pressure on a spinal nerve. During the procedure, the surgeon repairs or removes a spinal disc that is causing pain by compressing a nerve.