If you’re not a candidate for MIS, is open surgery the only other option?
Dr. Chou: You can still have minimally invasive surgery to treat your scoliosis, but you might not be able to have corrective surgery, which is when we try to straighten the spine. For instance, if someone with osteoporosis or heart or lung issues has severe leg pain from their scoliosis, we can use minimally invasive techniques to alleviate the leg pain, but we wouldn’t perform corrective surgery to address the entire scoliotic curve. In this way, MIS has actually opened the door for treatment for a lot of people who were otherwise not good candidates for surgery. They can still get the benefit of surgical treatment to reduce pain and discomfort without the risks of open, extensive surgery.
How do scoliosis patients do after undergoing MIS?
Dr. Chou: The outcomes data so far shows that if you do scoliosis surgery using minimally invasive techniques, the outcomes are just as good as with open scoliosis surgery in certain patient profiles. Specifically, research shows that MIS is just as effective for certain types of scoliosis; namely, degenerative scoliosis, or scoliosis in patients who are aging. Those patients do extremely well with minimally invasive scoliosis surgery compared with open surgery. However, this does not apply to all patients, and only certain patients have scoliosis that is amenable to MIS surgery.
Pain and disability are the primary reasons people seek care, so the number one outcome we look at is improvement in pain. We also look at improvement in mobility and functioning for the activities of daily life. Many of these patients have had results that are just as good with minimally invasive surgery as with open surgery; but again, these results are not universal and apply only to certain patients.
Dr. Hussain: As techniques and instrumentation evolve, and the longer we study MIS outcomes versus open surgery, the better we’ll understand not only what kind of scoliosis or spinal conditions we can treat, but also the long-term durability of these procedures.
What else should people know about scoliosis treatment?
Dr. Chou: If you need scoliosis surgery, not everyone needs their entire back fused. Some do need an extensive fusion, but what we really want to do is find the source of the pain, identify where it’s coming from, and target the surgical treatment. If we can restore function with a minimal amount of trauma and blood loss while speeding up recovery, that’s our goal.
Dr. Hussain: There are so many conservative treatments for scoliosis or spine conditions, and at Och Spine at NewYork-Presbyterian, the surgeons work closely with our non-operative colleagues to ensure patients have exhausted all treatment options before surgery is considered. This way, the doctors and patients are all on the same page in terms of the approach to surgery and the expectations of recovery.