I didn’t have scoliosis as a child but for some reason I developed it as an adult. Now I’m reaching my 40th birthday and can’t even walk a block without becoming breathless. I guess my lungs and heart are both compressed by the curved spine and twisted ribs. So — surgery has been suggested. Is there any chance I could get better without surgery?

Studies report that the natural history (what happens to a person with a condition like scoliosis over time) suggests that the deformity will continue to progress (get worse) without treatment. The spine will lose what flexibility it has. You are likely to experience pain and loss of function beyond what you have already described.

Reviewing 35 cases of adults who had fusion surgery for scoliosis later in life (between the ages of 40 and 66) showed the following conclusion. Today’s fixation devices and improved surgical techniques make spinal fusion for scoliosis in older adults not only possible but very beneficial.

The improvements in symptoms despite the loss of motion and possibility for post-operative complications is enough to satisfy the majority of patients. Patients report improvements in both mental and physical health after spinal fusion for scoliosis. Many are able to return to work after recovering.

There is one important factor to note: fusion to the sacrum comes with some additional limitations and restrictions. Patients should be prepared for that before surgery. The sacrum is included in the fusion process when the lumbar spine is just too unstable or too fragile to allow for movement at the last lumbar/first sacral (L5-S1) level.

Improvement without surgery isn’t likely though this is something you should discuss with your surgeon. If there’s time, bracing, exercising, and a combination of alternative approaches (acupuncture, osteopathy, electrical stimulation) can be applied with before and after X-rays taken to document any changes. Again, your surgeon will help you make a reasonable decision about this.