1. What are the indications for surgical treatment of scoliosis? Generally speaking, if the curvature of the spine is more than 40 degrees, and if conservative treatment fails to obtain a certain degree of correction or prevent further development of the curvature, surgical treatment should be considered. It should be noted that further progression of the curvature means that the degree of scoliosis increases by more than 5 degrees in six months with the correct wearing of braces. 2. When is the best age for scoliosis surgery? Generally speaking, the best age for scoliosis surgery is 10-20 years old. There are some special circumstances that need to be explained here. First, if the patient is a girl, it is best to undergo surgery after the onset of menstruation. This is because after the onset of menstruation, a girl indicates a growth spurt, when the curvature will have a more rapid development. Surgery during this period will prevent the curvature from worsening and losing the optimal period for surgery. The brace needs to be strictly worn before the onset of menstruation and surgery should be performed as soon as possible once menstruation has occurred. Secondly, if the patient is younger than 10 years old, but the curvature is already greater than 40 degrees and has progressed further while wearing the brace, surgery should also be performed as soon as possible so as not to wait until the curvature worsens after the age of 10 and lose the optimal time for surgery. Third, if the patient has congenital scoliosis and the scoliosis is due to a congenital cause such as hemivertebral body or vertebral body mal-segmentation, surgery should be performed as soon as possible. At this point, even though the curvature may not be too severe, since this deformity usually progresses quickly, failure to operate in a timely manner can also delay the timing of the surgery and lead to unsatisfactory corrections in the future. It is important to note that surgical correction of scoliosis is not 100%. The usual rate of correction is around 50-80%. Therefore the residual curvature after correction is different for a curvature of 100 degrees versus 60 degrees. Therefore, it is important to take advantage of the timing to get the ideal correction. 3. Can scoliosis be corrected after the age of 20? Generally speaking, the human body has stopped developing after the age of 20, and the curvature of scoliosis will not develop greatly. However, scoliosis may develop further, especially if the curvature is greater than 40 degrees. Surgery is also recommended because the stress on the curved spine accelerates the development of scoliosis as we age, and the complexity of surgery increases when we wait to treat conditions such as narrowing of the spinal canal due to scoliosis. Scoliosis after the age of 20 can also be treated, and the effectiveness of treatment depends on the degree of scoliosis and the stiffness of the curvature. Adults are less likely to be able to correct scoliosis than teenagers because the curvature is generally stiffer. 4. How long does the surgery take? Generally, it takes about 3 weeks of hospitalization. The first week is for pre-operative examination, followed by surgery. After surgery, you will need to stay in bed for 1 week, and then you can move around on the floor while wearing a protective brace. You can be discharged from the hospital 10-14 days after surgery. During the first month after surgery, patients need to mainly rest in bed, and can get up and move around such as eating, urinating and defecating. General daily life can be resumed in 2 months after surgery, but the brace needs to be worn for about half a year and then removed after the bone graft has fused. We ask the patients to take photos for review at 3, 6, 12 and 24 months after the operation, and we ask for a full-length front and side view of the spine when taking the photos. It is best to come to the hospital for the review, or if the distance is far, the films can be sent for review. Generally, it is recommended not to engage in physical labor and strenuous activities within one year after the surgery. 5.How much does the surgery cost? The general cost is 40,000-60,000 RMB. The surgery is performed with a domestic titanium pedicle screw system. If an imported internal fixation system is used, the cost will increase by one half to nearly double. 6, scoliosis surgery after the attention of the scoliosis surgery after the scoliosis surgery is generally within three days of the most painful, need to use pain medication. Many hospitals have pain pumps that can be used within three days after surgery, which are very effective in relieving pain. However, since anesthesia is used to relieve pain, it is important not to use it for too much and for too long. The pain will gradually decrease after three days and will be less severe a week after the surgery. One week after the surgery, the doctor will take pictures to check the bending correction and internal fixation. If the pictures are normal, the patient can try to sit up and stand up, holding the side of the bed or using a walker to help. Just get up to sit or stand, the patient will feel some dizziness, this is a long time bedridden and the body is still a little weak after surgery, don’t worry, get up a few times after the adaptation, dizziness will disappear. When you can stand up more naturally, and can stand for more than 10 minutes, you can take the mold for the support. Usually the brace will be ready in 2-3 days, and you can get up and walk around after wearing the brace. The purpose of wearing a brace is to protect the metal internal fixation device in the body, so as to prevent the internal fixation from loosening or breaking before the bone graft fusion is completed. The principle of wearing the brace is to wear it as long as you are up, at least six months, because you can’t wear it without it until the implants have fused. Therefore, it is very important to review the radiographs at 1, 3, and 6 months after surgery. If there is no abnormal feeling in the first month after the operation, you can also not take the film, but it is necessary to take the film in 3 and 6 months. Generally speaking, the first month after surgery is mainly bed rest, you can get up and walk around appropriately, eat, toilet, etc., but as long as you get up, you need to wear a brace to protect you. You need to be taken care of in your daily life within 1 month after surgery. In January, it is better to take pictures to check whether there is any loosening or change of the internal fixation, if there is no problem, you can gradually increase the time of activity. Many patients are able to return to their normal life or school within 2 months after surgery. When you get up and move around after surgery, it is normal to feel soreness in the lower back. After all, it takes 3-4 weeks for the muscles and other soft tissues at the surgical site to heal completely, so there is usually no problem. As long as there are no sudden changes in your body, such as severe back pain, loss of height, or bulging of the back again, there is no major problem. Recovery from surgery is gradual and should not be rushed. Generally speaking, strenuous activities are not allowed within six months after surgery, especially not bending, twisting, lifting heavy objects, etc., and confrontational activities or sports are not allowed within one year after surgery. If the patient feels that he/she can sit for 2-3 hours without discomfort, he/she can go back to school, but he/she is not allowed to participate in sports activities. You can start with half a day of school and gradually increase it later. In conclusion, it is very important to have a review within one year after the scoliosis surgery (March, June and December). Going to the hospital on time for a review or taking pictures and sending them to your doctor will help your doctor to understand the post-surgery recovery situation and enable you to have a better and faster recovery. If you feel any abnormal sensations during this period (sudden sharp pain at the surgical site, difficulty in breathing, bulging of the back, sudden change in height, etc.), you should contact your doctor immediately and go to the hospital to determine the cause of the problem and deal with it in a timely manner.