Scoliosis Surgery in Noida: Diagnosis, Treatment and Advanced Spinal Deformity Correction

By Dr. Pramod Saini | MS Orthopaedics, FNB Spine Surgery

Associate Director – Orthopaedic Spine Surgery

Max Super Speciality Hospital, Sector 128, Noida

Understanding Scoliosis and Its Treatment

Scoliosis is a three-dimensional deformity of the spine characterized by abnormal sideways curvature, vertebral rotation and altered spinal alignment. It may present as uneven shoulders, a prominent rib hump, asymmetry of the waist or a visible curvature of the back.One of the most common forms is Adolescent Idiopathic Scoliosis (AIS), which typically develops between 10 years of age and skeletal maturity, particularly during periods of rapid growth.

Although most cases are mild, progressive scoliosis can lead to significant spinal deformity, cosmetic concerns, altered spinal balance and, in severe cases, functional limitations.Early diagnosis and appropriate treatment are important for preventing progression and achieving favorable long-term outcomes.

What Are the Different Types of Scoliosis?

Scoliosis is broadly classified into:-

 Idiopathic Scoliosis: The most common form, occurring without an identifiable underlying cause. It is classified as infantile, juvenile or adolescent according to age of onset.- 

Congenital Scoliosis: Caused by abnormalities in vertebral formation or segmentation during fetal development.- 

Neuromuscular Scoliosis: Associated with conditions such as cerebral palsy, muscular dystrophy and other neuromuscular disorders.- 

Degenerative Scoliosis: Usually develops in adults due to degeneration of intervertebral discs and facet joints.- 

Syndromic Scoliosis: Associated with genetic or connective tissue disorders.Among these, adolescent idiopathic scoliosis is particularly important because spinal curvature may progress rapidly during skeletal growth.

How Is Adolescent Idiopathic Scoliosis Diagnosed?

Diagnosis involves a detailed clinical examination, assessment of spinal balance and standing whole-spine radiographs.

The severity of scoliosis is measured using the Cobb angle, which helps guide treatment.Other important considerations include skeletal maturity, curve flexibility, rate of progression and the presence of neurological abnormalities.

MRI of the spine may be recommended in selected patients to identify associated intraspinal abnormalities such as syringomyelia, Chiari malformation or tethered cord.

For patients requiring surgical correction, detailed assessment of curve patterns using the Lenke classification helps determine the appropriate fusion levels and correction strategy.

When Does Scoliosis Require Treatment?

Treatment depends on the Cobb angle, skeletal maturity and likelihood of progression.

Mild scoliosis (approximately 10–25 degrees): Usually managed with observation and periodic clinical and radiological follow-up.

Moderate scoliosis (approximately 25–40 degrees): Bracing is commonly considered in skeletally immature patients, particularly when progression is documented or anticipated.

Severe or progressive scoliosis (approximately 45–50 degrees or more): Surgical correction may be recommended, depending on curve characteristics, growth potential and overall spinal balance.These are general guidelines. 

Treatment decisions must be individualized.

Non-Surgical Treatment: Bracing and PhysiotherapyBracing plays an important role in preventing progression of adolescent idiopathic scoliosis.

Commonly used braces include the Boston brace, Rigo-Chêneau brace, Milwaukee brace and selected nighttime braces.Full-time bracing generally requires approximately 18–23 hours of daily wear and is continued until skeletal maturity or until the risk of progression becomes sufficiently low.

Scoliosis-specific physiotherapy, including Schroth-based exercises, may complement observation or bracing by improving posture, muscular control and body awareness.However, bracing and exercises cannot reliably correct every progressive structural deformity.

Advanced Scoliosis Correction SurgeryFor patients with severe or progressive deformity, posterior spinal fusion with segmental pedicle screw instrumentation is an established surgical treatment.

The procedure involves controlled three-dimensional correction of spinal curvature and rotation using pedicle screws, rods and appropriate corrective manoeuvres.In selected rigid or complex deformities, Ponte osteotomies may be performed to improve spinal flexibility and facilitate correction.

The primary surgical objectives are:-

 Restoration of coronal and sagittal spinal balance- 

Correction of spinal curvature and rotational deformity

- Prevention of further progression

- Preservation of appropriate mobile spinal segments

- Achievement of stable spinal fusion

The objective is not necessarily complete radiological straightening, but safe and durable deformity correction with balanced spinal alignment.

Role of Computer Navigation in Scoliosis SurgeryPedicle screw placement in scoliosis can be technically challenging because of vertebral rotation, narrow pedicles and altered anatomy.

Computer-assisted spinal navigation provides three-dimensional anatomical guidance and supports accurate pedicle screw placement, particularly in complex spinal deformities.

Navigation can improve surgical precision and assist in planning instrumentation trajectories, although it does not eliminate the inherent risks of surgery.

Importance of Intraoperative NeuromonitoringNeurological safety is a major consideration during scoliosis correction.

Intraoperative Neuromonitoring (IONM) allows assessment of spinal cord pathway function during surgery using techniques such as:- Somatosensory Evoked Potentials (SSEPs)- Motor Evoked Potentials (MEPs)Neuromonitoring helps identify potentially concerning neurological changes during correction, allowing the surgical and anaesthesia teams to respond promptly.It provides an additional layer of safety during complex spinal deformity procedures.

Recovery and Long-Term Outcomes

Patients are generally mobilized early after scoliosis correction, depending on their clinical condition.Hospitalization commonly lasts approximately 4–7 days, although this varies according to surgical complexity and recovery.Many adolescents can gradually resume school and routine activities within several weeks.

 Return to strenuous activities and sports depends on the extent of fusion and postoperative healing.Modern scoliosis correction techniques can provide substantial improvement in spinal alignment and prevent progression of the fused curve. The degree of correction and functional recovery vary between patients.

Dr. Pramod Saini – Orthopaedic Spine Surgeon for Scoliosis Surgery in NoidaDr. Pramod Saini is an orthopaedic spine surgeon with more than 15 years of experience in spine surgery, with particular expertise in complex spinal reconstruction, spinal deformity correction, scoliosis surgery and minimally invasive spine procedures.

He currently serves as Associate Director, Orthopaedic Spine Surgery, at Max Super Speciality Hospital, Sector 128, Noida.

Qualifications and Advanced Training

Dr. Saini's professional training includes:- 

MS Orthopaedics – SMS Medical College, Jaipur

- FNB Spine Surgery – P. D. Hinduja Hospital, Mumbai

- Advanced Orthopaedic and Spine Training

  All India Institute of Medical Sciences (AIIMS), New Delhi

- AO Spine Fellowship- Advanced Minimally Invasive Spine Surgery Fellowship/Training 

– National University Hospital, Singapore- Advanced Endoscopic Spine Surgery Training 

– Asian Spine Hospital, Hyderabad

His clinical practice focuses on complex spinal disorders requiring advanced surgical planning and instrumentation.

Areas of Surgical Expertise- Adolescent idiopathic scoliosis correction- Complex spinal deformity surgery- Posterior spinal fusion and instrumentation- Navigation-guided pedicle screw placement- Neuromonitoring-assisted deformity correction- Complex cervical and lumbar spine reconstruction- Revision spine surgery- Endoscopic spine surgery- Minimally invasive spinal fusion

At Max Super Speciality Hospital, Noida, scoliosis and complex spinal deformity surgeries are undertaken with an emphasis on meticulous preoperative planning, appropriate selection of fusion levels, precise instrumentation and neurological safety.

When Should You Consult a Scoliosis Surgeon?

Children and adolescents with uneven shoulders, a visible rib hump, progressive spinal curvature or significant trunk asymmetry should undergo evaluation by a qualified spine specialist.Early assessment is particularly important during the adolescent growth spurt, when scoliosis may progress rapidly.An experienced orthopaedic spine surgeon can determine whether the patient requires observation, bracing or surgical correction.

Scoliosis Surgery Consultation in Noida

Dr. Pramod Saini

MS Orthopaedics, FNB Spine Surgery

Associate Director – Orthopaedic Spine Surgery

Max Super Speciality Hospital, Sector 128, Noida

Specialist care for adolescent idiopathic scoliosis, complex spinal deformity correction, navigation-assisted spine surgery and posterior spinal fusion.This article is intended for patient education. The diagnosis and treatment of scoliosis require individualized clinical assessment and imaging.

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