Kerala's First Adult Scoliosis Correction Surgery Using O-Arm Technology — A Milestone at Institute of Spine and Scoliosis Surgery, VPS Lakeshore
Institute of Spine and Scoliosis Surgery · VPS Lakeshore Hospital · Kochi, Kerala
Kerala's First Adult Scoliosis Correction Surgery Using O-Arm Technology — A Milestone at Institute of Spine and Scoliosis Surgery, VPS Lakeshore
A schoolteacher who had spent decades standing before students now stands differently — upright, pain-free, and with a spine corrected by one of the most advanced surgical techniques available anywhere in the world. Her surgery, performed at the Institute of Spine and Scoliosis Surgery at VPS Lakeshore Hospital, Kochi, is a first for Kerala: the first adult scoliosis correction surgery performed using O-Arm intraoperative CT navigation technology in this state.
One year on from her operation, with confirmed solid spinal fusion and a full return to her profession, we are marking this milestone — not just as a surgical achievement, but as a call to awareness. Thousands of adults across Kerala are living with undiagnosed or untreated scoliosis, told that their pain is simply ageing. It is not. And today, world-class care for adult scoliosis is available right here.
Frequently Asked Questions
What is adult scoliosis — and is it different from scoliosis in children?
Most people associate scoliosis with teenagers. But scoliosis is very much an adult disease. It presents in two forms:
Progressive adolescent scoliosis: Curves that were never diagnosed or treated in childhood continue to worsen through adult life — at a rate of 0.5° to 2° every year.
De novo degenerative scoliosis: A fresh-onset spinal curve that develops in adults due to asymmetric degeneration of intervertebral discs and facet joints. This is the scoliosis of ageing — and it disproportionately affects post-menopausal women.
Unlike a teenager's flexible spine, the adult spine is stiff with arthritis and weakened by reduced bone density — making surgery far more technically demanding.
"Scoliosis does not retire when you turn 40. In fact, for millions of adults, it is only beginning. Kerala today has the technology and the expertise to address this silent epidemic."
— Dr. Krishna Kumar R, Director, Institute of Spine and Scoliosis Surgery, VPS Lakeshore HospitalHow widespread is adult scoliosis in Kerala and India?
The numbers are striking. Globally, adult scoliosis affects more than 8% of adults over 25 and up to 68% of adults over 60. Kerala has over 60 lakh people above 60 — the highest elderly proportion (16.5%) of any Indian state. Nationally, India has 15.3 crore people above 60, a figure set to reach 34.7 crore by 2050.
If even conservative prevalence rates are applied, hundreds of thousands of Keralites are living with clinically significant adult scoliosis — the majority undiagnosed, the vast majority untreated. Most have been told it is "just back pain" or "normal ageing." It is neither.
Why are post-menopausal women especially vulnerable?
The loss of oestrogen after menopause is a critical factor in spinal health. Oestrogen protects bone density and disc health. Without it, discs degenerate faster, bones lose their ability to support the spine symmetrically, and progressive curvature develops. Women in Kerala over 60 live, on average, 22 more years. That is 22 years in a progressively deteriorating spine — if the condition is not identified and treated.
Our patient — a post-menopausal schoolteacher — was dismissed for years with pain medication. When she arrived at Institute of Spine and Scoliosis Surgery, her scoliotic curve had become severe and was compressing her nerve roots. Today, a year after surgery, she is back in her classroom.
What is the O-Arm, and why does it matter in adult scoliosis surgery?
The O-Arm is an intraoperative CT scanner positioned around the patient on the operating table. Before each titanium screw is permanently placed, it provides a real-time three-dimensional image of the exact screw position within the vertebra.
In adult scoliosis, the vertebrae are rotated and deformed. Normal anatomical landmarks are distorted. The margin for error in screw placement is measured in fractions of a millimetre — a misplaced screw can mean permanent nerve injury or paralysis.
Conventional surgery relies on estimation and 2D fluoroscopy. The O-Arm provides confirmation. It is the difference between navigating with a map and navigating with real-time GPS — and in complex adult deformity surgery, that difference is the difference between safety and catastrophe.
Is adult scoliosis surgery safe? What should patients know about risks?
Adult scoliosis correction is major surgery, and its risks must be acknowledged honestly. These include nerve injury, blood loss, infection, and the possibility of incomplete fusion requiring further intervention. In elderly patients, cardiac and pulmonary risks from prolonged anaesthesia are also relevant.
At Institute of Spine and Scoliosis Surgery, all complex adult scoliosis surgeries are performed with O-Arm navigation and continuous Intraoperative Neurophysiological Monitoring (IONM) — a real-time alarm system that monitors spinal cord and nerve function throughout the operation. Our patient had no major complications. Her fusion is solid. She is working.
Equally important: the risk of doing nothing must also be weighed. Untreated progressive adult scoliosis leads to increasing nerve compression, progressive deformity, loss of mobility, and eventual dependency. The window for optimal surgical correction does not stay open indefinitely.
⚠ Warning Signs — When to See a Spine Specialist
- One shoulder noticeably higher than the other
- An uneven waistline or one hip appearing more prominent
- A progressive forward stoop or lean to one side
- Chronic back pain not responding to physiotherapy after 6 weeks
- Leg pain, numbness, or weakness alongside back pain
- Difficulty standing upright for more than a few minutes
- A change in posture noticed by family members over time
Why did a full year pass before this milestone was announced?
Because responsible medicine announces outcomes, not operations. The international benchmark for reporting adult scoliosis surgical results is a minimum of one year — the time needed for bony fusion to consolidate and for functional recovery to be fully assessed. We waited because our patient deserved certainty before the cameras arrived. At one year, her imaging confirmed solid fusion, maintained correction, and she had returned to full-time teaching. That is the story worth telling.
Where can patients in Kerala seek evaluation for adult scoliosis?
The Institute of Spine and Scoliosis Surgery at VPS Lakeshore Hospital, Nettoor, Kochi offers comprehensive evaluation and surgical treatment for adult scoliosis. Consultations are also available at the Edappally clinic. A diagnosis begins with a simple standing spinal X-ray and a specialist consultation — two steps that can change the trajectory of a patient's life.
For appointment enquiries, contact VPS Lakeshore Hospital, Nettoor, Kochi, Kerala.
Do Not Accept Pain as Normal
If you or someone you love has been living with back pain, a stoop, or uneven posture — a specialist evaluation may be the most important appointment you make this year.
Institute of Spine and Scoliosis Surgery · VPS Lakeshore · Nettoor, Kochi, Kerala
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