Many scoliosis patients as well as parents have recently asked about the timing of surgical treatment for scoliosis. This issue is indeed a concern for patients and there are quite a few inaccurate concepts. Here is an answer to the relevant questions in the form of a question and answer session as a reference for the majority of patients. What are the indications for surgical treatment of scoliosis? In general, surgery should be considered if the degree of scoliosis exceeds 40 degrees and a certain degree of correction or prevention of further progression of the scoliosis cannot be obtained with conservative treatment methods. It should be noted here that further progression of the curvature is defined as an increase in the degree of scoliosis of more than 5 degrees in six months with proper bracing. When is the best age for surgical treatment of scoliosis? The best age for surgical treatment of scoliosis is generally 10-20 years of age. There are some special circumstances that need to be explained here. First, if the patient is a girl, she should ideally undergo surgery after her first menstrual period. This is because the onset of menstruation in girls indicates a growth spurt, when the curvature will develop more rapidly. Surgery at this time will prevent the curvature from increasing and losing the best time for surgery. The brace needs to be worn strictly until the onset of menstruation, and the surgery should be performed as soon as possible once the menstruation starts. Second, if the patient is younger than 10 years old, but the curvature is already greater than 40 degrees and further progresses while wearing a brace, surgery should also be performed as soon as possible to avoid losing the best time for surgery by waiting until the curvature worsens after the age of 10. Third, if the patient has congenital scoliosis and the cause of the scoliosis is due to congenital causes such as hemivertebrae or poor vertebral segmentation, surgery should be performed as soon as possible. At this point, although the curvature may not be too severe, because this deformity usually develops relatively quickly, failure to operate in a timely manner may also delay the surgery and lead to unsatisfactory correction in the future. It is important to note that surgical correction of scoliosis is not 100%. The usual correction rate is about 50-80%. Therefore, the residual curvature after correction is different for a curvature of 100 degrees and 60 degrees. Therefore, you should take advantage of the timing to obtain the desired correction. Can scoliosis be surgically corrected after the age of 20? Generally speaking, after the age of 20, the body has stopped developing and the curvature of scoliosis generally does not develop significantly. However, there is a possibility of further development, especially if the curvature is greater than 40 degrees. Therefore, surgery is also recommended because the stress on the curved spine accelerates the development of spondylolisthesis as the age of the spine increases, and the complexity of surgery increases when the spinal canal stenosis due to hyperplasia is treated. Scoliosis can also be treated after the age of 18, and the effectiveness of the treatment depends on the degree of scoliosis, the stiffness of the bend, etc. Adults are not as effective as teenagers because the bend is generally more rigid. We have treated many scoliosis cases over the age of 20, and the correction rate is usually around 50%, and patients are more satisfied. How long does the surgery take? To undergo scoliosis surgery in the hospital, you generally need to stay in the hospital for about 3 weeks, with the first week being the pre-operative examination and then the surgery. After the surgery, you usually need to rest in bed for 1 week, and then you can move around on the floor while wearing a protective brace. Since the surgical tract is closed with intradermal sutures, there is usually no need to remove stitches, so the patient can be discharged from the hospital 10-14 days after the surgery. For the first month after surgery, the patient needs to rest in bed, and can get up and move around such as eating and urinating and defecating. Usually you can resume general daily life in 2 months after surgery, but the brace needs to be worn for about 6 months and then removed after the bone graft is fused. We ask patients to have their films taken at 3, 6, 12 and 24 months after surgery for review. It is best to come to the hospital for review, or if you are traveling a long distance, you can send in the films you have taken for review. Generally, it is recommended not to engage in physical work or strenuous activities for one year after surgery.