Earlier this week, Channel 4 aired a documentary called Save My Child. It focused on two young people with lifelong health conditions and their families’ efforts to raise the funds for private treatment.
One of the children featured was Mia, a 15-year-old girl with scoliosis. Here’s a clip from the programme:
Mia’s curved spine, along with the scoliosis brace that she had to wear for 23 hours a day, meant that she was in near-constant pain. At the start of Save My Child, we see Mia lying awake at night and struggling with everyday tasks like tying her shoelaces.
Frustrated with the long waiting lists for spinal fusion surgery – and fearing that Mia’s condition would only get worse with time – her family started researching alternatives. Eventually, they decided to travel to Turkey so that Mia could undergo vertebral body tethering (VBT) surgery.
The Channel 4 programme primarily focused on how Mia’s family managed to raise tens of thousands of pounds to pay for private surgery. What it didn’t do was take a critical look at the VBT procedure itself and how effective it actually is.
Is VBT a good alternative to spinal fusion surgery?
First of all, it’s important to note that VBT is a rather controversial topic here in the UK. It was the subject of much discussion at the recent British Scoliosis Society conference in Cardiff – many British families go abroad for VBT, with Germany and Turkey the most popular destinations, but in many cases there are no formal standards in place for this procedure. And if complications occur back home, the NHS must then pick up the cost of fixing an operation that was paid for privately in a different country!
Fortunately, the outcome for Mia was a positive one (“I’m a lot happier now,” she told Channel 4), but here at the Scoliosis SOS Clinic, we’ve met a number of scoliosis patients who weren’t so lucky. One family came to see us after their daughter had undergone the VBT procedure in Turkey – they were concerned that she didn’t look any different, and in the end they signed her up for a ScolioGold treatment course, an option they had previously passed up in favour of the VBT route.
Potential complications of VBT
If you need another reason to think twice before going abroad for VBT surgery, we have met multiple scoliosis patients who ended up suffering from pleurisy after the procedure. This is a sharp pain in the chest that occurs when you take a deep breath.
Still other patients found that the tethering had been done on the wrong side of the spine, making their scoliosis worse and creating nerve complications.
Finally, it should be noted that the death rate for VBT is 3%. This is significantly higher than spinal fusion surgery.
A safer alternative to spinal fusion
While vertebral body tethering may become a more viable option in the future, there simply isn’t enough evidence of its effectiveness just yet (this is the main reason why VBT isn’t currently available on the NHS).
The Scoliosis SOS Clinic’s physiotherapy-based scoliosis treatment courses offer a non-invasive, low-risk alternative to scoliosis surgery. We have helped patients of all ages to manage their severe spinal curves and live happier, more active lives. On many occasions, our treatment programme has reduced the angle of the patient’s curvature to a point where they’re no longer a candidate for surgery at all!
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Further Reading:
Scoliosis, a condition where the patient’s spine curves sideways, can be found in roughly 4% of the global population. Of those 4%, some have a very mild spinal curve that only measures
10-20 degrees, while others are more severely affected by the condition.
Generally speaking, once a scoliosis patient’s
Cobb angle has progressed past the 40-degree mark (50 degrees in some territories), doctors will recommend
spinal fusion surgery as the best course of action.
Now, there’s a reason why spinal fusion surgery is the standard treatment for severe scoliosis. The operation has a good overall success rate, achieving the desired effect (reducing curvature and preventing further progression) with no complications in the majority of cases.
However, there are a number of reasons why a scoliosis sufferer may wish to seek alternatives to spinal fusion:
- All surgical procedures carry a certain level of risk – possible complications include infection and problems related to the anaesthesia used to sedate patients during surgery.
- Spinal fusion surgery in particular can lead to a number of other complications, although the risk is very low. Read about the risks associated with scoliosis surgery here.
- The spinal fusion procedure tends to be followed by a long recovery period, during which the patient may temporarily experience pain and reduced mobility/flexibility.
- Depending on where you live, there may be a long waiting list for spinal fusion surgery, and time is imperative when your spinal curvature is still progressing. (This has been a particularly big problem in Ireland recently.)
- The long-term effects of spinal fusion surgery on patients are still relatively unknown, especially as techniques keep changing. However, some patients may continue to experience or develop pain, while others find that a secondary curve forms above or below the fused area. Occasionally, it is necessary to undergo another operation to extend the fusion.
Treating scoliosis without surgery
With the above in mind, it’s perhaps easy to understand why a number of scoliosis patients are reluctant to undergo spinal fusion surgery. So what other treatments are available?
Mild to moderate cases of scoliosis are frequently treated using a
Boston brace, but this approach doesn’t reverse the spinal curvature – it just aims to prevent it getting worse, and therefore it’s no use if your scoliosis is already quite severe or if you are an adult.
However, there are a number of non-surgical techniques that have been shown to reduce the Cobb angle and effectively combat the symptoms of scoliosis. Here at the Scoliosis SOS Clinic, we combine a number of these methods into our own unique scoliosis treatment programme called
ScolioGold.
Here are some of the techniques we use to provide scoliosis sufferers with a real alternative to scoliosis surgery:
If you would like to learn more about our non-surgical scoliosis treatment courses, please call 0207 488 4428 or contact us online to arrange a consultation.
In many mild cases of scoliosis (i.e. where the patient’s spinal curve is unlikely to progress to an extent that will cause major changes in their appearance or respiratory health), spinal fusion surgery will not be recommended. For those with a severe curve (45-50 degrees or more), surgery is usually recommended – particularly if the patient is a child, as their scoliosis will likely increase as they grow. Scoliosis surgery is also recommended to those whose curves have progressed rapidly over a period of monitoring their condition, as it can prevent further progression and health complications.
While spinal fusion surgery is an effective treatment for some patients – and may be the only viable option for those with severe scoliosis – it is important to consider your full range of options before undergoing this procedure. You should also take time to consider any possible risks or complications of undergoing scoliosis surgery, as is advised before any major operation.
Risks to consider before undergoing spinal fusion surgery
- Back Pain – In some cases, patients will continue to experience back pain even after undergoing spinal fusion surgery, due to what is sometimes referred to as ‘failed back surgery syndrome’. While the surgery itself may have been a success, this does not necessarily mean that the patient will experience a full resolution of their pre-op symptoms.
- Failure of Fusion – This occurs when the bone grafts used to complete the operation fail to fuse into solid bone, which can be caused by excessive movement, poor placement of screws and rods, or even the use of anti-inflammatory medication. This can sometimes lead to failure of implants, which can cause breaks, pullouts and chronic pain. If there is no pain and the curve seems to be stable, a broken rod may not be removed.
- Neurological Complications – Some complaints which may occur soon after surgery include a loss of skin sensation, loss of strength in feet and legs, loss of bowel and bladder control, and in very severe cases, paralysis. These changes can be temporary or permanent and only occur in a very small number of cases, particularly in their most serious form.
The paper Neurological complications in adult spinal deformity surgery states: “Surgery of the lumbar spine for ASD has a neurologic complication rate between 0.5 and 17% and is dependent upon approach (anterior, lateral, or posterior), number of fusion levels [and] case complexity.”
This means that the more severe or complex your scoliosis curvature is, the higher the chance that you will experience some neurological complications following spinal fusion surgery.
Other possible surgery risks include:
- Infection
- Self-image (due to scarring)
- Osteoarthritis
- Limited range of motion/flexibility
Is it possible to avoid these risks and complications?
If you are particularly concerned about the potential risks and limitations posed by surgery, it may be possible to eliminate the need for this procedure by reducing your spinal curvature through non-surgical techniques. Here at the Scoliosis SOS Clinic, we have treated a huge number of spinal surgery candidates who came to us in an effort to avoid spinal fusion.
Using our ScolioGold treatment programme (which combines a selection of established non-surgical techniques), we have managed to not only reduce the Cobb angle of our patients, but also provide them with a lasting method to manage the symptoms of their scoliosis.
Post-spinal fusion surgery
We also treat many patients who have already undergone spinal fusion surgery and are seeking help to recover from the procedure more quickly. For many of our post-op patients, the primary complaint is the level of pain experienced after surgery, which can be successfully reduced using our therapeutic techniques. Another key issue for post-surgery patients is mobility, which can also be improved with the guidance and supervision of our experienced physiotherapists.
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