What Happens During Spinal Deformity Correction?

During spinal deformity correction, the surgeon realigns the affected vertebrae to improve your spinal alignment and stabilize the corrected position. Once the desired alignment is achieved, rods and screws help maintain the corrected position as your bones heal. This added stability can help improve your posture and make daily movement easier.

At Total Orthopedics & Sports Medicine, our spine surgeon, Dr. Dante Leven, evaluates how your deformity affects your pain, mobility, and daily function. He then reviews the severity of the deformity and identifies which areas require correction. Based on these findings, he selects the most appropriate approach to restore stability while protecting your mobility and long-term function. Call 855-321-6784 to schedule your appointment.

How Is Spinal Deformity Correction Performed?

Surgeons perform spinal deformity correction by repositioning the spine to restore a more balanced alignment. They use surgical techniques based on the type, location, and severity of the deformity. Throughout the procedure, the surgical team monitors your spinal cord and nerves to help protect nerve function.

Here’s the step-by-step process your surgical team follows during spinal deformity correction:

• Anesthesia: Your surgical team gives you anesthesia before your surgeon begins the operation.
• Surgical access: The surgeon reaches the affected area through the approach selected during planning.
• Nerve monitoring: The surgical team checks spinal cord and nerve signals throughout the procedure.
• Release of stiff areas: Tight joints or tissues may require release if they limit correction.
• Curve correction: Your surgeon gradually repositions the affected spinal levels toward the planned alignment.
• Stabilization: Screws and rods help hold the corrected position.
• Fusion preparation: A bone graft may support healing between the treated vertebrae when fusion is required.
• Final check: Imaging helps confirm the correction and hardware position before the incision is closed.

Does Every Spinal Deformity Need Surgery?

No, not all spinal deformities require surgery. If your curve causes mild symptoms and remains stable, non-surgical treatments such as activity modifications, bracing, medications, or injections may help manage discomfort. However, your surgeon may recommend surgery when the deformity progresses, causes persistent pain, or begins to affect nerve function.

In addition, surgery may become necessary when a severe curvature limits your mobility, makes it difficult to stand upright, or causes nerve compression. Your surgeon may also recommend surgery if weakness, numbness, or other neurological symptoms develop. These changes may indicate that the deformity has begun to affect your movement and nerve function.

If you are experiencing these symptoms, you may still be unsure whether your deformity actually requires surgery. You may also worry that waiting could allow the curve, pain, or functional limitations to worsen. Our surgeon, Dr. Dante Leven, reviews your symptoms and imaging to determine whether your condition meets the criteria for surgical correction. He then explains what correction could realistically achieve and helps you understand the next step. Contact us today to schedule an evaluation.

How Do Surgeons Plan the Spine Correction?

Dr. Dante Leven first identifies where the deformity originates and how your body compensates for the imbalance. He reviews full-length standing X-rays to assess Cobb angle, curve severity, pelvic position, overall balance, and flexibility. Based on these findings, he determines which spinal levels require treatment and how much correction can safely restore balance. He may also use computer modeling for preoperative surgical planning and correction strategy.

In addition, before finalizing the surgical plan, our board-certified spine surgeon assesses the following factors that can affect the procedure and your recovery:

• Measure alignment: Assess sagittal and coronal alignment on standing X-rays.
• Check curve flexibility: Determine which areas remain flexible and which are rigid.
• Review imaging: Examine MRI or CT scans for degenerative diseases, trauma-related changes, or nerve compression.
• Assess bone health: Check bone strength when poor density could affect fixation or fusion.
• Review your health: Review medical conditions and current medications before surgery.
• Reduce surgical risks: Address nutrition, smoking, and other factors that may affect healing.
• Prepare for blood loss: Estimate bleeding risk and prepare strategies to limit significant blood loss.

How Do Surgeons Decide How Much Correction Is Needed?

Surgeons decide how much correction you need by comparing your current spinal alignment with individualized alignment targets. They evaluate your age, curve flexibility, pelvic position, and overall balance rather than aiming for a perfectly straight spine. These factors help determine a correction that restores balance without placing unnecessary stress on nearby spinal levels.

In fact, a multicenter study of 773 patients with adult spinal deformity found that ideal spinopelvic alignment varies with age. The researchers concluded that surgeons should consider a patient’s age rather than applying the same alignment goal to everyone.

What Techniques Are Used to Correct Spinal Deformity?

Surgeons correct spinal deformity with correction techniques such as spinal fusion, instrumentation, osteotomy, and vertebral column reconstruction, depending on the curve. Less rigid curves may require fewer corrective steps, while severe or fixed deformities may require bone cuts to restore alignment. Your surgeon selects the technique according to your specific spinal structure.

Each technique addresses a specific part of the correction and stabilization process, such as:

Spinal Fusion

Spinal fusion helps maintain the corrected position after your surgeon adjusts the curve. For more extensive deformities, the fusion may extend across four or more vertebral levels. During the procedure, the surgeon first prepares the surfaces of selected vertebrae. Bone grafts then help promote new bone growth between them. As healing progresses, the treated vertebrae form a stable segment. This stability helps preserve the correction over time.

Spinal Instrumentation

Spinal instrumentation gives your surgeon precise control during spinal deformity correction surgery. The surgeon places screws at selected levels and connects them with rods. These components help guide the vertebrae toward the planned position. After the correction, the spinal hardware supports the treated area while the fusion heals. Furthermore, the rods and screws used for this purpose are commonly made from titanium or cobalt-chromium alloys.

Spinal Osteotomy

A spinal osteotomy helps correct a rigid spinal curvature that cannot move enough with standard techniques. Your surgeon removes or reshapes a precise section of bone to create controlled movement. This allows greater adjustment at the stiff area. The type of spinal osteotomy surgery depends on the location and degree of correction required. Common types include:

• Smith-Petersen osteotomy (SPO): Removes bone from the back of the spine to create flexibility for a smaller correction.
• Pedicle subtraction osteotomy (PSO): Removes a wedge of bone through the vertebra to provide greater correction at one level.

Vertebral Column Reconstruction

Vertebral column reconstruction may address a severe curvature that requires substantial structural correction. Your surgeon removes part or all of a selected vertebral segment to create space for repositioning. The surgeon then reconstructs and stabilizes the area. Because this is a complex surgical procedure, careful planning and neurological monitoring are essential.

A recent study of 55 patients with severe, rigid spinal deformities reported an average 68% correction after vertebral column resection. Because this technique involves substantial correction near the spinal cord and nerves, the researchers also tracked intraoperative neuromonitoring alerts and neurologic complications

What Type of Anesthesia Is Used During Surgery?

General anesthesia is used during spinal deformity surgery, so you remain unconscious and do not feel pain throughout the procedure. Your anesthesia team continuously monitors your breathing, blood pressure, and other vital signs. At the same time, they coordinate anesthesia with neurological monitoring to track nerve function.

Which Surgical Approach Is Used for Correction?

Surgeons commonly use a posterior, anterior, or combined approach to correct spinal deformity. A posterior approach provides access from your back, while an anterior approach reaches the spine from the front and may require rib removal in certain cases. On the other hand, a combined approach may be used when correction requires access from both sides of the spine.

The location and complexity of your deformity also help guide which surgical approach provides the most effective access. For example, a curve limited mainly to the thoracic or lumbar region may allow access from one direction. But rigid curves, severe rotation, prior fusion, or multilevel changes may require a combined approach to address different aspects of the deformity.

How Do Surgeons Protect the Nerves During Surgery?

During surgery, surgeons continuously monitor electrical signals from your spinal cord, nerves, and muscles to help protect neurological function. These signals alert the surgical team if nerve activity changes during the correction. If a change occurs, your surgeon pauses the procedure, identifies the possible cause, and adjusts the surgical steps before continuing.

To monitor these signals throughout the correction, the surgical team may use several specialized tests:

• Somatosensory evoked potentials (SSEPs): Track sensory pathways from the arms and legs through the spinal cord.
• Motor evoked potentials (MEPs): Check the pathways that carry movement signals from the brain to the muscles.
• Electromyography (EMG): Detect abnormal muscle activity that may indicate irritation of a spinal nerve.
• Triggered EMG: Helps check whether pedicle screws are positioned too close to a nerve.

Together, these tests allow the surgical team to monitor your nerves throughout the procedure, a process called intraoperative neuromonitoring (IONM). The team compares nerve signals at different stages of the procedure, especially after major corrective steps. This allows your surgeon to spot changes in nerve signals and adjust the procedure to help protect your nerves. It also helps reduce the risk of serious nerve injury, including paralysis.

What Helps Reduce Blood Loss During Surgery?

Surgeons reduce blood loss during surgery with blood-conserving medications, careful surgical techniques, and specialized equipment. They may also use a cell-saver system to collect and return your own blood during the procedure. These methods can reduce blood loss and lower the need for donor blood transfusions.

Your individual risk of significant blood loss depends on the extent of the correction. Longer procedures, multilevel surgery, or an osteotomy may increase this risk. For this reason, your surgical team checks your hemoglobin level, reviews blood-thinning medications, and addresses anemia before surgery when necessary.

How Do Surgeons Check Alignment During Surgery?

Surgeons check spinal alignment during surgery with real-time imaging and direct measurements of the corrected spine. Through this imaging, they can see the position of the vertebrae and spinal hardware before the procedure ends. Then they compare these findings with the planned correction and make adjustments as needed.

After confirming the alignment on imaging, surgeons perform the following final checks:

• Overall balance: Confirm the corrected position supports better posture.
• Hardware position: Confirm the rods and screws remain properly positioned.
• Nerve signals: Make sure nerve-monitoring signals remain stable before finishing the correction.
• Curve correction: Check that the abnormal curvature has achieved the intended degree of correction.
• Final stability: Check that the treated area has enough stability to support healing and fusion.

How Long Does Spinal Deformity Surgery Take?

Spinal correction typically takes about four to eight hours, although the exact time varies with the complexity of the deformity. A procedure that treats several spinal levels or requires an osteotomy may take longer. In contrast, a less extensive correction may require fewer hours in the operating room.

A multicenter study of 544 patients reported an average operative time of about 6.3 hours. Procedures took longer when more spinal levels were fused or additional techniques, such as osteotomy, were required. The extra time required for multilevel correction may also affect outcomes. For example, a study of 1,540 adults who had spinal deformity surgery found that longer operative times were associated with a higher risk of complications. This risk increased as procedures extended into the 7–8-hour and 9+-hour ranges.

How Long Does Recovery Usually Take?

Recovery after spinal deformity correction typically takes about 3 to 6 months for most daily activities. In fact, in a study of 188 adults who underwent spinal deformity surgery and were employed before surgery, 70% were working full-time by six months. During this period, you gradually rebuild strength, mobility, and endurance through rehabilitation. However, complete recovery and bone healing after fusion surgery may continue for 6 to 12 months, especially after a more extensive correction.

As your spine heals, your recovery generally progresses through the following stages:

• First few days: You typically spend 2–5 nights in the hospital and begin short walks. Some patients may also wear a brace for support during the initial healing.
• Weeks 1–4: Gradually increase walking as it is essential for recovery, and resume light activities as your mobility improves. But avoid lifting more than 10 pounds during the first month.
• Months 2–3: You may gradually return to your usual daily routine as your strength improves, depending on your surgeon’s guidance.
• Months 3–6: Your strength and function continue to improve as you gradually return to high-impact activities.

How Much Spinal Correction Can Surgery Achieve?

Surgery can often correct a spinal curve by about 50% to 70%. But the exact degree of correction varies with the type and flexibility of the deformity. Instead of making your spine completely straight, spinal correction surgery helps restore a more natural alignment to improve posture. Your surgeon also assesses bone strength and overall spinal balance to guide the planned degree of correction.

A study of adults with severe lumbar scoliosis reported an average major-curve correction of about 66% after surgery. The findings show that substantial correction is possible, although the final result depends on the individual deformity and surgical approach. Another study of adults undergoing scoliosis surgery reported substantial curve correction across several surgical approaches, with correction rates varying by technique.

A correction percentage from a study cannot tell you exactly how much correction your own spine needs. The key question is whether the planned correction matches the imbalance created by your specific deformity, rather than simply achieving the largest possible curve reduction. Dr. Dante Leven uses your imaging and alignment measurements to set an individualized correction target before surgery. If you want to know what correction is realistic for your spine, schedule an evaluation with our spine surgeon.

Will Your Spine Be Completely Straight After Surgery?

No, your spine will not always be completely straight after surgery. Instead, the goal is to achieve balanced, natural alignment and improve function while avoiding excessive correction. Some curvature may remain if further correction could place unnecessary stress on your spine or surrounding structures. Therefore, surgeons focus on restoring overall balance and function rather than focusing on complete straightening of the spine.

Can a Spinal Deformity Return After Surgery?

Yes, a spinal deformity can return after surgery, but recurrence depends on the type of deformity and how your spine heals. Loss of correction may occur due to incomplete fusion, hardware complications, or changes at nearby spinal levels. Regular follow-up helps your surgeon identify early signs of deformity progression or other changes that could affect the surgical result.

Here’s how our surgeon, Dr. Dante Leven, may address a loss of correction after surgery:

• Repeat imaging: Use standing X-rays or CT scans to identify any changes in alignment.
• Check the fusion: Look for areas where the bones did not fully heal together.
• Assess the hardware: Check rods, screws, and other implants for loosening, breakage, or movement.
• Monitor mild changes: Follow small changes over time when they do not cause significant symptoms.
• Manage symptoms: Use medications or selected injections when symptoms can be treated without further surgery.
• Consider revision surgery: Recommend another procedure if the deformity progresses, hardware fails, or nerve problems develop.

Book an Evaluation With Dr. Dante Leven for Spinal Deformity Correction!

A spinal curve can gradually change how you stand, walk, and maintain balance. Over time, you may need frequent breaks or struggle with activities you once managed comfortably. As these limitations increase, you may question whether correcting the deformity could help you stand, walk, and function more comfortably.

At Total Orthopedics & Sports Medicine, Dr. Dante Leven explains what surgery can realistically change and how it may improve quality of life after recovery. He also discusses the expected recovery and potential risks before you decide. If surgery is appropriate, he develops a correction strategy focused on relieving pain and reducing further progression. For coordinated evaluation and treatment under one roof, call 855-321-6784 or visit our Linden clinic to consult our spine surgeon.

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