Treatment Orthopedics


Treatment usually begins with physical therapy and medications, including:

  • Anti-inflammatory medications and occasional mild narcotics for pain relief
  • Epidural steroid injections to relieve leg pain
  • Physical therapy to stabilize the spine


For patients whose back or leg pain doesn't respond to medication and physical therapy, surgery may be considered. Spinal surgery to treat adult scoliosis is complex, considering the average patient's age and the possibility of other medical conditions, such as osteoporosis, but a patient's age should not rule out surgery.

Research has shown that age is not as important as a person's health in determining the success of the surgery and rate of recovery. Patients considering surgery are encouraged to adapt a healthy diet and weight, and participate in an exercise regimen before and after surgery.

Spinal Fusion Surgery

Spinal fusion surgery may be recommended for patients who have pain despite other treatments.

Fusion surgery is performed to fuse the vertebrae so the spine can't bend. This stabilizes the spine, preventing excessive motion and collapse. Surgery also corrects the deformity, when needed. The goal is to correct the curve by 50 percent or more.

Other Procedures

In some cases a more minimally invasive approach may be possible. Corrective surgery may require less significant bone cutting when combined with an advanced procedure called the transpsoas approach. This procedure differs from traditional approaches because the surgeon accesses the space between the discs from a patient's side, rather than from the front or back, sparing major back muscles, bones and ligaments from an incision.

The transpsoas approach enables a surgeon to correct a side-to-side curvature and improve the front to back balance, known as sagittal balance. Restoring sagittal balance is perhaps the single most important factor contributing to a good outcome following treatment for adult scoliosis.

One of these procedures, involving an incision on the patient's side, is called extreme lateral interbody fusion.

The UCSF Spine Center specializes in treating complex cases of scoliosis in adults, using state-of-the-art surgical repair and rehabilitation, which results in limited anesthesia, quicker patient mobilization and recovery, and ultimately improved quality of life.

UCSF Spine Center

Doctors at the UCSF Spine Center are experts in the surgical repair and rehabilitation for adult scoliosis, including high-risk cases. Our team is part of a high volume service with over 10 years of experience and over 150 medical research papers published on adult spinal deformity.

Treatment advances at UCSF, including minimally invasive surgical approaches, advanced neuromonitoring techniques and 3-dimensional imaging, allows for limited anesthesia, quicker patient mobilization and recovery and ultimately improved quality of life. We also perform "co-surgery," in which two spine surgeons operate together on a patient, rather than just one surgeon. UCSF is one of only a few centers in the country to offer this approach. Research by UCSF doctors, published in the January 2013 issue of Spine Deformity, found that co-surgery for complex spinal disorders results in reduced surgical times, blood loss and complications for certain complex cases.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

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