Severe scoliosis can present problems with cardiopulmonary function. The definition of severe scoliosis varies depending on the source. Most authors consider 60 degrees the benchmark for scoliosis to be called severe. 

There are two main factors that go into deciding whether or not to have major spinal fusion surgery. The first is the cosmetic appearance which most orthopedic surgeons say is the number one concern of the patients and parents prior to learning of the potential cardiopulmonary effect. The second is the fear of health problems not only in the immediate future but also down the road.

You can also opt for scoliosis surgery clinics in Singapore.

The studies conclusively show that increased risk of pulmonary function loss stems from thoracic structural scoliosis with a cobb measurement greater than 60 degrees in the frontal plane.

Curves with apexes below T9 generally do not have any restrictive pulmonary issues because there is no rib cage deformity and much less spinal rigidity. Thoracic curves with apexes higher than T7 are also excluded. 

Therefore any child not showing a measurable decline in pulmonary function should not be subjected to scoliosis surgery using medical necessity rationale and should be thoroughly aware that the procedure is for cosmetic appearance.

Scoliosis surgery, with and without thoracoplasty, is a common practice in the management of adolescent idiopathic scoliosis, and those who are considering this procedure should understand the results and the potential risks involved in achieving the desired cosmetic improvement.