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I've had scoliosis of my spine my whole adult life. It has gradually gotten worse and worse. I'm going to have surgery to fuse the entire lumbar spine to the sacrum and up to T10. How can I tell if it's too late to even bother?

Your orthopedic and/or neurosurgeons should be able to advise you on this question. They will take your age, general health, and condition of the spine into consideration when making the suggestion to have surgery (or not). Likewise, they will tell you what kind of surgery is needed (e.g., anterior versus posterior fusion, use of hardware such as screws or hooks). Possible problems and complications will be discussed with you. This can range from infection to pseudoarthrosis (false joint) and many things in between. The biggest problem after long fusions of this type is movement at the segment due to the formation of a pseudoarthrosis. Studies show that this complication occurs in up to 24 per cent of patients who have the type of surgery you are considering. Unless the spine is so brittle from osteoporosis, fusion is usually very successful. The spine is supported in a more upright position. The patient can breathe better. With improved posture maintained and the spine stabilized, there is less back pain. Sometimes the implant devices create problems and have to be removed. Most of the time, the hardware and bone grafting used form a solid, immovable fusion.

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