Debate: Degenerative Scoliosis: To Operate or Not to Operate
If surgery is contemplated, one must consider complete preoperative medical evaluation. Postoperative care also must involve an appropriate interdisciplinary team and include established care patterns for at-risk patients. The surgical procedure itself may need modification to achieve lesser goals than would be attempted in a more robust patient. An informed consent discussion should include the patient and her support group. Risks and complications must be fully understood, and the patient will ultimately choose between those risks and her quality of life. The surgeon should offer options and probabilities, but the patient must bear the consequences of that choice.