Surgical Options for Adult Scoliosis: A Complete Guide

Scoliosis is often thought of as a condition that affects adolescents, but many adults also live with significant spinal curves. In some cases, these curves are mild and manageable with conservative care. In others, they cause pain, stiffness, and even nerve-related symptoms that can severely affect quality of life. For these patients, surgical options for adult scoliosis may offer lasting relief and correction.

In this guide, we’ll break down what adult scoliosis is, when surgery becomes necessary, and the different surgical techniques available today. You’ll learn the benefits and risks, what recovery looks like, and which patients are best suited for each procedure. By the end, you’ll have a clear understanding of the treatment pathways—and how to make an informed decision with your spine specialist.

You can also read: Spine surgery for scoliosis treatment.

Understanding Adult Scoliosis

Adult scoliosis refers to an abnormal sideways curvature of the spine in patients over 18. While scoliosis often develops in adolescence, many adults develop curves later in life due to spinal degeneration. There are two main types:

• Adult idiopathic scoliosis: The continuation or progression of a curve first diagnosed in childhood or adolescence.
• Adult degenerative scoliosis: Curves that appear later in life, usually due to disc degeneration, arthritis, or osteoporosis.

Common symptoms include chronic back pain, uneven shoulders or hips, leg weakness, tingling, or numbness due to nerve compression. In severe cases, scoliosis can affect balance, lung capacity, and overall mobility.

When Is Surgery Recommended for Adult Scoliosis?

Not every adult with scoliosis needs surgery. In fact, most patients start with conservative treatments such as physical therapy, pain medications, and spinal injections. However, surgery may be recommended when:

• The spinal curve exceeds 40–50 degrees and continues to worsen.
• Pain becomes severe and does not respond to conservative management.
• Neurological symptoms like numbness, tingling, or leg weakness appear.
• The curve causes spinal imbalance, making it hard to stand upright or walk.

Imaging studies—X-rays, MRIs, and CT scans—help spine specialists determine whether surgery is the most effective option.

Surgical Options for Adult Scoliosis

Spinal Fusion Surgery for Scoliosis

Spinal fusion is the most common procedure for adult scoliosis. The surgeon permanently connects two or more vertebrae using bone grafts, rods, and screws. Over time, the graft fuses with the bone, eliminating movement between the vertebrae and stabilizing the spine.

Fusion can correct significant curvature, reduce pain, and prevent further progression. While it limits flexibility at the treated levels, most adults notice little change in daily mobility since nearby vertebrae compensate.

Decompression with Fusion

Many adults with scoliosis also suffer from spinal stenosis, where nerves are compressed by bone spurs, herniated discs, or the curve itself. In such cases, a laminectomy or foraminotomy may be performed to relieve nerve pressure. To ensure stability after decompression, the procedure is often combined with spinal fusion.

This approach is especially beneficial for patients whose scoliosis causes leg pain, numbness, or sciatica.

Osteotomy Procedures

In very severe scoliosis (curves over 70–80 degrees) or cases where previous surgeries have failed, an osteotomy may be required. This involves cutting and reshaping bones to achieve a more natural alignment.

Though highly complex, osteotomies can deliver dramatic improvements in posture, balance, and pain relief. However, they come with higher risks and longer recovery times, so they are reserved for select patients.

Minimally Invasive Scoliosis Surgery (MISS)

Advances in technology have made it possible to correct certain scoliosis curves using minimally invasive techniques. Instead of one large incision, surgeons use multiple small incisions, tubular retractors, and real-time imaging to place screws and rods with less disruption to muscles and tissues.

Benefits of MISS include less blood loss, shorter hospital stays, and faster recovery. However, not all patients are candidates—this option is best for moderate curves without severe deformity.

Benefits of Scoliosis Surgery in Adults

The impact of scoliosis surgery can be life-changing. Patients often report:

• Reduced pain: Relief from both chronic back pain and radiating nerve pain.
• Improved posture: Straighter alignment of the spine and more balanced shoulders and hips.
• Better mobility: Ability to walk longer distances and engage in daily activities with less discomfort.
• Prevention of progression: Halting the worsening of spinal deformities that could otherwise lead to disability.
• Enhanced quality of life: Better sleep, restored confidence, and increased independence.

Risks and Considerations

As with any surgery, scoliosis correction has potential risks. The most common include:

• Infection at the surgical site.
• Blood clots (deep vein thrombosis).
• Hardware complications, such as screw loosening.
• Spinal fluid leaks.
• Adjacent segment disease, where nearby vertebrae degenerate faster after fusion.

Adults may also experience longer recovery times compared to adolescents, since age-related changes in bone quality and overall health can slow healing. This makes it critical to select a highly skilled and experienced spine surgeon.

Recovery After Adult Scoliosis Surgery

Typical Recovery Timeline

• Week 1: Hospital stay, gradual walking with assistance, pain managed with medication.
• Weeks 2–6: Return to light daily activities, no heavy lifting or twisting.
• Months 2–3: Structured physical therapy begins to restore strength and flexibility.
• After 6 months: Most patients regain mobility, return to work, and resume low-impact activities.

Recovery Tips for Success

• Follow your physiotherapist’s home exercise program.
• Maintain good posture and use ergonomic support when sitting.
• Avoid smoking, as it slows down bone healing.
• Focus on nutrition—calcium, vitamin D, and protein help bone fusion.

Patients should call their doctor if they experience fever, increasing wound redness, sudden weakness, or severe pain.

Alternatives to Surgery for Adult Scoliosis

Before considering surgery, many patients try non-surgical treatments such as:

• Physical therapy: Builds core strength and improves posture.
• Medications: Pain relievers, anti-inflammatories, or nerve-targeting drugs.
• Epidural injections: Reduce inflammation and nerve pain temporarily.
• Bracing: Offers support but does not correct adult scoliosis.
• Lifestyle changes: Weight management, low-impact exercise like swimming or walking.

While these measures may help in mild cases, surgery often becomes the most effective long-term solution when pain and deformity significantly impair quality of life.

FAQs: Surgical Options for Adult Scoliosis

How successful is scoliosis surgery in adults?

Success rates range from 70–90%, depending on curve severity and overall health. Most patients experience pain relief and improved alignment.

How long is the hospital stay after scoliosis surgery?

The average stay is 5–7 days, though minimally invasive approaches may reduce this to 3–4 days.

Is scoliosis surgery riskier in adults than in teenagers?

Yes. Adults often face higher complication rates due to age-related factors like bone density loss or preexisting health conditions.

Can scoliosis surgery fully straighten the spine?

While most surgeries improve spinal alignment significantly, the goal is not complete straightening but reducing curvature and restoring balance.

What is the recovery time for scoliosis surgery in adults?

Most patients resume daily activities within 2–3 months, but full recovery can take 6–12 months.

Choosing the Right Surgical Option for Adult Scoliosis

Adult scoliosis can be a painful and debilitating condition, but surgery provides hope for patients who no longer respond to conservative treatments. From traditional fusion to minimally invasive approaches, today’s surgical options are safer and more effective than ever.

If you’re considering surgery, the most important step is consulting with an experienced spine specialist. Dr. Gustavo Navarro, founder of Spine Center Vallarta in Mexico, is internationally recognized for his expertise in scoliosis and complex spinal surgeries. With advanced training and a patient-centered approach, Dr. Navarro has helped many adults regain mobility, confidence, and quality of life.

If you’re struggling with scoliosis-related pain or imbalance, don’t wait. Schedule a consultation with Dr. Navarro to discuss whether surgery is the right solution for you.