09/04/2026
When Should Surgery Be Considered for Children with Scoliosis?
In clinic, many parents ask the same questions:
“Doctor, is it too early for surgery now?”
“Can we wait until my child is older?”
In reality, the decision to proceed with scoliosis surgery is not based on age alone. It depends on three key factors:
1. The child’s growth stage
2. The degree of spinal curvature
3. Whether the curve is progressively worsening
❌ Not all scoliosis cases require surgery ❌
Orthopaedic spine specialists use the Cobb angle to measure and determine the severity of scoliosis. Generally:
👉 10° – 20°: Mild scoliosis. Regular observation is sufficient, with follow-up X-rays every 4–6 months.
👉 20° – 45°: Moderate scoliosis. If the child is still growing, bracing is usually recommended to prevent rapid progression.
👉 Above 45°: Severe scoliosis. Surgical treatment is typically recommended.
Of course, some parents choose to “wait and see,” trying stretching exercises, manual correction, or other non-surgical approaches. As a spine specialist, when patients with severe scoliosis choose to delay surgery, I provide several key monitoring indicators as guidance. The bottom line is: once these surgical warning signs appear, patients should return immediately for evaluation and proceed with surgery without further delay.
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📖 When might a spine specialist recommend “waiting”?
When the child is still growing and has mild scoliosis, non-surgical treatments may be used to control progression, such as:
• Bracing
• Targeted spinal exercises and core muscle training
• Regular X-ray monitoring
The goal of these treatments is not to fully “correct” the curve, but to slow progression and allow the child to grow safely.
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📖 When should you ❌ NOT wait?
Surgery is recommended if the following conditions are present:
• Cobb angle exceeds 45°
• Rapid progression over a short period
• Bracing is no longer effective
• Noticeable impact on appearance or body balance
If severe scoliosis continues to progress, it may lead to:
• Chronic pain
• Body asymmetry
• Impaired heart and lung function
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💉 What surgical options are available in Malaysia?
Currently, there are two main surgical approaches for adolescent scoliosis in Malaysia:
1. Traditional Spinal Fusion Surgery
2. Non-fusion minimally invasive surgery: VBT (Vertebral Body Tethering)
Each method has different indications and suitability depending on the patient’s condition. More details are available via the link provided in the comments.
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The key in scoliosis treatment is timing — not too early, not too late — to prevent the condition from progressing into a more complex stage.
If surgery has already been recommended but you prefer to wait, close and regular monitoring is essential. This ensures the optimal timing for treatment becomes clear.
Translate from
Dr. Lee Chee Kean
Spine Specialist Malaysia & Consultant Orthopaedic
Post
小孩脊椎侧弯，要等到什么时候才决定手术？
在门诊里，很多家长都会问我同一个问题：
“医生，现在是不是太早做手术？”
“可不可以等孩子长大一点？”
其实，脊椎侧弯是否需要立刻安排手术，并不是单纯看年龄，还要看三个关键因素：
1）孩子的生长阶段
2）侧弯角度
3）侧弯是否在持续恶化
❌ 不是所有侧弯都需要手术 ❌
脊椎骨科医生会用 Cobb angle（Cobb角）来衡量和定断侧弯的严重程度。一般来说：
👉 10° – 20° 属于轻度侧弯，这阶段只需要定期观察，每 4–6 个月复诊拍X光。
👉 20° – 45° 乃中度侧弯，如果孩子仍在生长，我一般会建议孩子穿上支具（brace），防止侧弯快速地持续恶化。
👉 超过45° 便是重度侧弯了。这情况我会建议患者考虑手术治疗。
当然，也有家长选择“再等等”——尝试拉伸运动、徒手矫正或其他非手术疗法。作为脊柱专科医生，我在面对重度脊椎侧弯的患者决定要“再等等”的时候，会提供几个关键的评估指标给他们做参考。底线是：一旦触及这些手术警示点，就必须立即回诊，安排手术，别再延误。
📖 脊椎骨科专科医生在什么情况下会建议让孩子“再等一等”？
1）当儿童的脊椎还在生长。
如果孩子是轻度侧弯并且还在生长期，我会先利用非手术治疗来控制侧弯，例如：
- 支具治疗（Brace）
- 给孩子设计背脊运动及核心肌群训练
- 要求家长定期 X 光追踪
这些方法的目标不是把侧弯“矫正回来”，而是尽量拖慢恶化速度，让孩子可以“安全地”长大。
📖 什么时候 ❌ 不应该再等？
如果侧弯患者出现以下情况，我就会建议手术：
- Cobb角度超过45°
- 侧弯在短时间内快速恶化
- 支具治疗已经无法控制
- 开始影响外观或身体平衡
因为严重侧弯如果持续发展，未来可能带来：
- 慢性疼痛
- 身体不对称
- 影响心肺功能
💉 马来西亚目前有哪些手术选择？
目前在马来西亚，治疗青少年脊椎侧弯主要有两种手术方式。
1）传统脊椎矫正融合手术（Spinal Fusion）
2）非融合微创手术：VBT（Vertebral Body Tethering）
这两者之间有何不同，患者在什么条件下比较适合进行哪个矫正手术，阅读链接我放在留言区。🔗
脊椎侧弯的治疗的关键在于“什么时候是最合适的时机” --- 不早做亦不晚做，是为了避免让侧弯发展到更复杂的阶段。
如果已经被建议手术，仍坚持“再等等”，那么，密切地定期追踪、时刻观察侧弯变化，也能让治疗时机变得清晰。
Dr. Lee Chee Kean
Spine Specialist Malaysia & Consultant Orthopaedic
#脊椎侧弯
