Most children with scoliosis never need an operation. When surgery is recommended, it is to stop the curve getting worse and to correct it as much as can be done safely, not to make the spine perfectly straight. This page explains when surgery is considered, why we don't wait for pain, and how to choose a surgeon and hospital.
Reviewed by Dr. Kshitij Chaudhary — Last reviewed October 2026
When is surgery needed?
This depends on the stage of growth, the position and size of the curve, the curve pattern, and the surgeon's judgement. In general:
- A curve in the upper or mid-back reaches 45 to 50 degrees. Surgery may be recommended even if your child is still growing
- A lower-back curve reaches about 35 to 40 degrees
- A brace hasn't controlled the curve and there is a lot of growth left
- Growth is finished and the curve is over about 50 degrees. These curves tend to keep growing slowly through adult life, by about 1 to 2 degrees a year
At the end of growth, curves under 40 degrees tend not to progress, although lower-back curves under 40 degrees might. For curves between 40 and 50 degrees, some progress and some don't, and advice varies. You will never be pushed into it. Most children with scoliosis never need an operation.
If you're unsure about the advice you've been given, you're welcome to send your scans and reports for a second opinion.
What is the goal of surgery?
The goals are to stop the curve getting worse, and to correct it as much as can be done safely. Stopping progression prevents the health problems linked to severe scoliosis (curves over 70 to 80 degrees), such as breathing trouble, heart and muscle weakness, and pain. Full correction usually isn't possible or safe, and we don't aim for a perfectly straight spine.
Why not wait until growth is finished, or until it hurts?
With a moderate curve, your child probably feels well. Surgery is advised before pain starts because the aim is prevention. A smaller, more flexible curve in a teenager is easier to correct than a larger, stiffer curve in an adult. That usually means a less complicated operation, lower risk, and sometimes fewer vertebrae fused. Recovery is also easier in the teenage years, when life is less complicated in terms of school, family and career.
Waiting a long time, especially during growth, can allow the curve to grow so that more levels have to be fused. Waiting longer than 6 to 12 months deserves a conversation with your surgeon. We can help you decide how long it is safe to wait.
What should I look for in a surgeon and hospital?
Choose a surgeon who specialises in spinal deformity in children and teenagers, has successful experience treating it, and is happy to talk the plan through with you and your child. Choose a hospital with a team used to caring for adolescents during and after spine surgery, including:
- An anaesthetist experienced with children
- Specialised paediatric staff
- An intensive care unit
- Spinal cord monitoring during surgery
- Good pain management and other paediatric specialists on hand
A second opinion is always reasonable. Please ask for one if you'd like it.
This information is for general education and does not replace a consultation with your doctor.