Understanding the Surgery Your Teen Might Need
If your teenager has been diagnosed with adolescent idiopathic scoliosis (AIS)—an abnormal sideways curvature of the spine—you may have heard about posterior spinal fusion surgery. This is one of the most common treatments for moderate to severe curves. During the operation, surgeons fuse vertebrae together and use metal rods to straighten the spine.
But here's the question surgeons have been debating: should they use traction (gentle pulling forces) during the surgery to help straighten the curve even more? A new comprehensive review of 18 studies has looked at whether this extra step actually makes a difference.
What Did the Research Find?
The meta-analysis examined five direct comparison studies involving 450 patients. The results are nuanced—and that's important for you to understand.
When surgeons used intraoperative traction, the spine correction was slightly better on paper (about 5.5 percentage points more correction). However, this difference was not statistically significant, meaning it could have happened by chance. The research couldn't definitively prove that traction made a meaningful clinical difference.
On the positive side, traction didn't appear to increase risks. The studies found no significant difference in blood loss, operative time, transfusion rates, or overall complications compared to surgery without traction. This is reassuring for parents worried about safety.
However, there was one important finding: neuromonitoring alerts (temporary nerve signals during surgery) were reported more frequently when traction was used, particularly with higher weights and in more complex cases. The good news? Most of these alerts were reversible—they resolved once doctors reduced or released the traction. No permanent nerve damage was consistently linked to this.
What This Means for Singapore Families
In Singapore and across Asia, scoliosis treatment follows international best practices. Your child's surgeon will likely already be considering whether traction is appropriate based on your teen's specific curve severity, spine characteristics, and other individual factors.
This research suggests that the decision to use traction shouldn't be black-and-white. Rather, it's a personalised choice your surgeon should discuss with you. Some teens may benefit from it; others may achieve excellent results without it. What matters most is that your surgeon carefully monitors nerve function during surgery—something that's standard practice in Singapore's leading hospitals.
For Asian families, it's also worth noting that scoliosis severity can vary, and some curves are more complex than others. This research validates the importance of having your teen evaluated at a centre experienced in treating adolescent scoliosis, where surgeons can make individualised recommendations rather than applying a one-size-fits-all approach.
Three Things You Should Do Now
- Have a detailed conversation with your surgeon about their approach. Ask whether they recommend traction for your child's specific case, and why or why not. Understanding their reasoning helps you make informed decisions together.
- Ask about intraoperative neuromonitoring (nerve monitoring during surgery). This is the key safeguard. Ensure your chosen surgical centre uses this technology, as it allows doctors to detect and respond to nerve stress immediately—whether traction is used or not.
- Focus on the complete picture, not just curve correction numbers. The best surgical outcome isn't just about achieving the straightest spine—it's about safety, function, and minimising risks. Ask your surgeon about their overall approach to these factors.