Scoliosis Surgery in Turkey

Scoliosis is a sideways curve of the spine. It is most often diagnosed in the early teen years, and the spine can curve to either side and in different parts of the back. The cause of most scoliosis in children is unknown. Scoliosis can also appear in adults as a result of wear and tear on the spine with age.

Most scoliosis is mild. But some curves get worse as a child grows, and a severe curve can cause pain and breathing problems, because the curved spine may press on the lungs. In adults, pain is one of the most common problems.

Doctors monitor children and teens with mild scoliosis through regular follow-up visits, which usually include a physical exam and X-rays to see whether the curve is getting worse. Many people with scoliosis don’t need treatment. Some children need a brace to stop the curve from worsening, and some need surgery to correct it. In adults, treatment usually aims to relieve pain, and surgery is considered only in specific situations.

This guide explains when scoliosis surgery is an option for children, teens and adults, and gives a general overview of techniques, risks and recovery. It also explains what to know and ask if you are considering scoliosis surgery in Turkey. This information is for general education. It doesn’t guarantee any result and doesn’t replace evaluation by your doctor.

What is scoliosis and what are its types?

Scoliosis is a sideways curve of the spine. Seen from behind, it looks like the letter C or S. In most cases the spine also twists as it curves, so one side of the rib cage or back muscles sticks out more than the other. Signs can include:

• Uneven shoulders, or one shoulder blade that looks more prominent.
• An uneven waist.
• One hip higher than the other.
• One side of the rib cage pushing forward.
• One side of the back poking out when bending forward.

Scoliosis is not caused by carrying a heavy backpack or by poor sitting posture. It usually doesn’t cause pain in children and teens, while pain is relatively more common in adults. Most people with scoliosis live normal lives and take part in their usual activities.

Knowing the type of scoliosis matters, because the reasons for surgery differ from one type to another:

• Idiopathic scoliosis: the most common type, with no identified cause. It can run in families, but most children with scoliosis have no family history of it. It usually appears in the early teen years.
• Congenital scoliosis: caused by a problem in how the spinal bones form before birth.
• Neuromuscular scoliosis: linked to conditions affecting the nerves and muscles, such as cerebral palsy or muscular dystrophy.
• Other types: scoliosis can follow chest-wall surgery in infancy, or be related to conditions of the spinal cord.
• Degenerative scoliosis: develops in older adults as the spine wears down with age.

Females and males get mild scoliosis at about the same rate, but the chance of the curve worsening and needing treatment is relatively higher in females.

This article focuses on idiopathic and degenerative scoliosis. Surgical decisions for congenital and neuromuscular scoliosis differ and need more specialized evaluation.

When should you see a doctor?

See a doctor if you notice signs of scoliosis in your child or teen, even if they seem minor. A mild curve can form slowly and painlessly, and the family may not notice it. Sometimes teachers, friends or sports teammates are the first to see it. Also see a doctor if an adult with scoliosis develops new back pain. Scoliosis along with severe pain, weakness or numbness needs prompt evaluation.

Evaluation usually starts with a physical exam and X-rays to measure the curve. Your doctor may refer you to a pediatric orthopedic surgeon or a surgeon who specializes in spinal deformity to plan your treatment.

Does every case of scoliosis need surgery? What are the other treatment options?

No. The path depends on age, the size of the curve and the likelihood that it will progress.

Monitoring

For mild curves, the doctor usually schedules regular visits, an exam and X-rays to make sure the curve isn’t increasing. Very young children may not need treatment because the spine can improve with growth, but specialist follow-up remains important.

Bracing

A brace is sometimes prescribed for a young person who is still growing and whose curve is getting worse. A brace does not correct an existing curve, but it may keep it from progressing to the point where surgery is needed. Its effect has been debated for years, and not every specialist recommends it.

A multicenter clinical trial provided important evidence about bracing in teens at risk of curve progression who were still growing. Those who wore a brace were relatively less likely to reach the level at which surgery is usually recommended than those who were only observed, and the benefit increased with more hours of brace wear.

However, this result should be read with caution:

• It is a single trial in a specific group of teens.
• Some participants chose their own treatment rather than being randomly assigned.
• A fair number of teens in the observation group did not reach the point of surgery either.
• The researchers noted that current criteria for prescribing braces may be too broad, so some patients may be treated unnecessarily.

So the result does not mean a brace is right for every case.

Exercises

Recent reviews and guidelines suggest that scoliosis-specific physiotherapy exercises, supervised by a trained therapist, may help slow curve progression in some growing teens. Promising evidence has come from clinical trials, but study quality varies and the evidence is still developing. Exercises don’t replace regular follow-up, and they don’t replace a brace where a specialist recommends one. General physical activity is beneficial and is not usually restricted unless your doctor advises it. International guidelines from a specialist society cover non-surgical treatment of scoliosis during growth, with a caution that differences in study design limit how widely their recommendations can be applied.

How does the doctor decide that surgery is appropriate?

The decision is not based on a single number on an X-ray report. The surgeon measures the curve angle (the Cobb angle) and commonly uses it as a guide, but it is not an absolute rule: the measurement itself has a margin of error, and it doesn’t capture the three-dimensional twist of the spine. So the surgeon weighs it against:

• The location and type of the curve.
• The patient’s age and how much growth remains.
• The likelihood and speed of progression.
• Symptoms such as pain or nerve pressure.
• General health.
• Results of earlier non-surgical treatment.

The chance of a curve worsening quickly usually drops after growth is complete, but large curves may continue to progress slowly even in adulthood. Over time they can cause chronic pain or breathing problems. The goal of surgery is mainly therapeutic: to stop the curve from worsening and protect function. Improved appearance follows as a result of correcting the curve.

Who may not be a good candidate for surgery? The surgeon assesses this case by case. Surgery may not be suitable for someone whose curve is mild and stable, whose general health makes the risks of surgery outweigh the expected benefit, or whose symptoms are not expected to improve with surgery. For adults who are not well enough to undergo an operation, a brace may be considered as an alternative for pain relief.

The reasons for surgery differ by group:

• Children and teens: surgery may be considered if the curve keeps getting worse despite other treatment, or if it is severe and growth has stopped.
• Adults: surgery may be considered if the curve is severe or clearly worsening, if pain is severe and other treatments haven’t helped, or if nerves are irritated or compressed.

What is scoliosis surgery like in children?

Early-onset scoliosis

This is scoliosis that appears in early childhood. Infants and young children may not need surgery, and treatment often starts with observation. A cast or brace may be used to slow progression while the child grows.

Growth-friendly surgery

If the curve keeps getting worse, the problem with conventional surgery is that it relies on spinal fusion, and fusion stops growth in the fused area. For this reason surgeons avoid it in young children when possible and turn to growth-friendly surgery. Rods are placed alongside the spine to hold the curve while letting the spine keep growing. The rods are lengthened periodically, and when growth is complete they are removed and a final correction is often performed.

How the rods are lengthened depends on their type:

• Traditional rods: each lengthening requires a small surgical procedure.
• Magnetically lengthened rods: lengthened without a surgical incision.

The evidence for these operations is relatively shorter-term than for fusion. The most frequently recorded complications involve the implants, such as screw pull-out or rod breakage, and loss of alignment, and unplanned additional operations may be needed. On the other hand, magnetic lengthening reduces the number of operations that traditional rods require, and reviews note that it remains an important option for surgeons despite its complications.

Some magnetically lengthened rod systems have been subject to safety alerts from regulators in some countries, and their status changes over time. So ask the surgeon about the specific device being proposed and about any safety alerts concerning it.

This explanation is general. It doesn’t mean every technique is available in every Turkish hospital. Confirm this directly with the center.

What families should ask about

Some of these treatments require long-term follow-up, which may continue until the child finishes growing. Before deciding, ask for the full follow-up plan: how often the child will be seen, where, and how follow-up will be managed once you return home. For some families it may be more suitable for the follow-up team to be close to where they live.

Scoliosis or bracing can also affect body image and self-esteem in children and teens. It is fine to seek emotional support when needed.

To tell scoliosis apart from other conditions: problems of the cervical (neck) spine in children are different from scoliosis and have their own page on cervical spine surgery in children in Turkey.

What is scoliosis surgery like in teens?

The most common type in teens is idiopathic scoliosis. The decision depends on remaining growth, which is estimated from the exam and X-rays, sometimes including a hand X-ray.

Spinal fusion

This is the most widely used operation, and the most common approach is fusion from the back. The general steps are:

• Implants (screws or hooks) are placed in the bones of the back.
• A rod is attached to them to bring the spine to a straighter position.
• Bone graft is placed so that the bone heals together across the affected vertebrae.
• Only the curved vertebrae are fused, and the rest of the spine keeps its motion.

Patient materials from specialist organizations state that surgery usually improves rib prominence and waist and hip asymmetry, although improvement in shoulder balance is less predictable. They also note that some asymmetry remains and does not disappear completely. The patient loses motion in the fused vertebrae but keeps flexibility above and below. Most patients can return to most of their previous activities, although vigorous contact sports may be discouraged.

Non-fusion surgery (such as vertebral body tethering)

This is proposed for some teens who are still growing and have a large curve. The idea is to correct the curve while preserving motion and growth, instead of fusing. But the evidence is not yet mature:

• A meta-analysis indicates that it does reduce the curve, but with overcorrection in some cases, tether breakage, and the need for additional surgery. It recommends refining the technique to reduce complications.
• Some experts consider that its long-term results are not yet known, and that the chance of needing an additional operation may be relatively higher than after fusion, with limited comparative evidence.
• For now, fusion remains the most widely established option.

Where experts disagree

Some researchers consider the comparative evidence supporting fusion surgery to be limited. They point to the lack of randomized trials comparing it with no surgery, and to inconsistent reporting of long-term complications. On the other hand, materials from surgical societies state that fusion succeeds in stopping curve progression and improving appearance. This disagreement is one more reason for the decision to be carefully considered, and for seeking a second opinion when needed.

Recovery

Patients usually start walking early after the operation, and the length of the hospital stay varies by case and center. Most teens return to school after some weeks and to sports after some months, and the surgeon sets the timing for each patient. A brace may or may not be required after surgery, depending on the surgeon’s judgment.

What is scoliosis surgery like in adults?

The two forms of scoliosis in adults

Scoliosis in adults may be a continuation of adolescent scoliosis that was never treated. More often it is degenerative scoliosis, which develops with gradual wear of the spine and may come with arthritis or osteoporosis. The curve, or the wear that goes with it, can press on nerves, as in spinal stenosis treatment in Turkey. Chronic back pain in adults is more strongly linked to large curves that were not treated since childhood.

Non-surgical treatment

Most adults don’t need surgery. The main goal is pain relief, and treatment may not be needed if the curve isn’t severe and doesn’t cause pain:

• Pain relievers: usually the first step.
• Physical therapy and exercise: these usually don’t improve the curve but may reduce pain. Talk to a specialist before starting.
• Injections around the nerves: when nerves are under pressure; their effect is usually short-lived.
• Bracing: rarely used in adults, and used to relieve pain, not to correct the curve.

When is surgery considered, and what are the options?

It is considered when the curve is severe or clearly worsening, when pain is severe and other treatments haven’t helped, or when nerves are irritated or compressed. The options include:

• Decompression to relieve pressure on nerves, including laminectomy surgery in Turkey.
• Spinal fusion to stabilize the spine and restore its balance.

The goal is usually to relieve symptoms and restore balance to the spine, not to straighten it completely. The operation is major, and medical sources state that full recovery can take a long time, up to a year or more, with practice varying from place to place. It is relatively more helpful for pain that radiates into the legs than for back pain itself, though the evidence varies. It may not remove all symptoms, and it limits motion in the fused vertebrae.

How strong is the evidence?

Most studies comparing surgery with non-surgical treatment in adults were not randomized. People who choose surgery may be more disabled from the start, a selection bias that can exaggerate the difference between the groups. Reviews report relatively better results on average for those who chose surgery, but these are indirect comparisons.

Some researchers also note that loss to follow-up in non-surgical groups was high in some studies, which limits the conclusions. For this reason it is wise to try appropriate non-surgical treatment before deciding, and to discuss the benefits and risks fully.

How is scoliosis correction surgery performed in general?

Details vary from patient to patient. This is a general description:

• Preparation: a physical exam and X-rays; other tests and an anesthesia assessment may be requested depending on the case. In adults, general health and bone strength are assessed.
• Anesthesia: general anesthesia.
• The operation: the surgeon brings the spine to a straighter position using implants and rods, and places bone graft to complete the fusion where needed. The number of fused vertebrae depends on the shape of the curve.
• Safety during surgery: a full team takes part in the operating room, and a specialist usually monitors spinal cord function throughout. Various methods are used to reduce bleeding. A blood transfusion is occasionally needed, and in some centers the patient’s own blood can be recovered and returned.

These details vary between centers, so ask the surgeon about their own practice.

What are the possible risks and complications?

There is no single complication rate, because figures vary with the study, age group and technique. But the generally agreed list includes:

• Nerve injury: the most feared complication, and a rare one. It can cause permanent numbness or leg weakness, and in rare cases paralysis and loss of bowel and bladder control.
• Bleeding, and the need for transfusion that may come with it.
• Wound infection, which is usually treated with antibiotics.
• Implant problems: for example rods that move, or bone graft that doesn’t heal well, which may lead to additional surgery. The possibility of later surgery exists after any scoliosis operation and is not a minor matter.
• Blood clots, which have been listed among the risks of surgery in adults.
• Persistent pain or pain that doesn’t fully go away, especially back pain in adults.
• Remaining asymmetry and loss of motion in the fused vertebrae.
• In children treated with growth-friendly rods: repeated operations and visits, implant problems and loss of alignment.
• In people who have had vertebral body tethering: a chance of overcorrection or tether breakage, and a chance of needing an additional operation.
• General risks related to anesthesia and major surgery.

Your surgeon determines the risks in your specific case after evaluation, so ask directly.

What are recovery and follow-up like?

• Pain: expected after surgery; it usually improves over days and is controlled with medication. Strong pain relievers are used for the shortest time possible.
• Movement: early walking is encouraged, and heavy lifting and sports are restricted for a period your surgeon determines. Constipation and numbness around the incision can occur.
• Care at home: the patient learns safe movement, and physical therapy may be needed depending on the case.
• Follow-up: includes exams and X-rays. The implants usually stay in place, and MRI is generally safe with them, with some distortion of the image around the spine.

Contact the medical team immediately for: fever; redness, discharge or increasing swelling at the incision; new weakness or numbness in the legs; loss of bowel or bladder control; difficulty breathing; or leg swelling and pain.

What affects the results?

• The type of scoliosis and the size and flexibility of the curve.
• Age and how much growth remains.
• General health and bone strength.
• The surgical team’s experience and quality of planning.
• Commitment to follow-up and post-operative instructions. Even with bracing, results were linked to the number of hours the brace was worn.

What should you know about scoliosis surgery in Turkey?

Some medical centers in Turkey offer spine evaluation and surgery to patients who come from abroad. Capabilities and experience vary from one center to another, so no single judgment applies to all of them. This page is part of our section on orthopedic and joint surgery in Turkey.

Before you travel

• In many cases you can send medical reports, images and X-rays for a preliminary assessment. This assessment doesn’t replace an in-person exam, and the opinion may change after the patient is seen.
• The surgeon determines the length of stay based on the case and the expected recovery, so don’t rely on a general number.
• Follow-up after you return home: Who will follow your case in your country? How will reports and X-rays be transferred? What happens if a complication appears after you return? When is air travel allowed? This matters most for children who need long-term follow-up.

How much does scoliosis surgery in Turkey cost?

O9 Medical estimates the initial cost of scoliosis surgery in Turkey at roughly $7,000 to $16,500 USD. This is a preliminary, non-binding estimate, and the final price is set after your case, X-rays and medical reports are evaluated.

The price of scoliosis surgery varies from patient to patient depending on several factors:

• The type of surgery and the number of vertebrae involved.
• The implants used.
• The length of the hospital stay and intensive care, if needed.
• Tests and anesthesia.
• Follow-up and physical therapy.
• Travel, accommodation and companion costs.

Before you decide, ask for a written statement that clarifies:

• What the cost includes: surgeon’s fees, implants, hospital stay, tests and follow-up.
• What it doesn’t include: for example travel and accommodation outside the hospital.
• How any complications or additional surgery would be handled if needed, and who bears the cost.

The number alone isn’t enough to judge the quality of care. What matters more is a detailed medical evaluation and a clear follow-up plan for after you return home.

Choosing a center or doctor

To explore centers and doctors, you can visit the page on orthopedic and joint surgery hospitals in Turkey and the page on spine health and scoliosis. What matters is not to rely on advertising alone, and to ask the questions in the next section.

What O9 Medical provides

We help you understand your options, arrange the transfer of your medical reports, communicate with centers, and coordinate appointments and translation. The medical decision remains between you and your doctor. We don’t promise any result or pressure you to decide, and we encourage you to get a second opinion whenever you need one.

What questions should you ask the surgeon before deciding?

• What exact type of scoliosis do I (or does my child) have, and why is surgery being proposed now instead of monitoring or bracing?
• What non-surgical alternatives are available, and why do they suit or not suit my case?
• How many scoliosis operations have you performed for patients of the same age group and the same type of scoliosis?
• Which technique do you propose and why? Are there any safety alerts about this technique or device?
• What is the goal of the correction? What will the surgery not achieve?
• What are the risks specific to my case? How are complications managed if they occur? Might I need later surgery?
• Is spinal cord monitoring used during the operation? What methods does your center use to reduce bleeding?
• What is the recovery plan, and what length of stay do you recommend?
• What is the follow-up plan after I return to my country? Whom do I contact in an emergency?
• What does the cost include and what does it not include?

Medical note: this information is for general education. It does not replace consultation with a specialist doctor and is not a diagnosis or a prescription.