Should teen undergo spinal surgery?

DEAR DR. GOTT: My 17-year-old son has scoliosis. We have seen a specialist who had him wear a brace, but he couldn’t breathe with it on. I think it’s now time for surgery, but his primary-care doctor wants him to wait. What should we do and how long should we wait?

DEAR READER: Children and teens with mild scoliosis are often monitored with X-rays periodically to determine whether the curvature worsens. In many instances, treatment isn’t necessary. A brace will not cure the condition, nor will it reverse the curvature, but it may prevent advancement. There may come the time when surgical intervention is appropriate.
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Patient opposes surgeon’s recommendation

DEAR DR. GOTT: I’m a 57-year-old man happily living with my wife of 34 years. Although I watched my diet, exercised, and have no family history of cardiovascular disease, I had a 90 percent cardiac blockage in 2009 and ended up having a heart-catheterization procedure and stent insertion. I saw the signs early and now take 40 milligrams of simvastatin.

Because I had paid my deductible and co-insurance, I saw a back surgeon about my back, which had been giving me problems for years. After X-rays, a CT and MRI, he determined that I have a vertically herniated disc between my fourth and fifth vertebrae. He said I need a spinal fusion, which would involve going through my abdomen. He gave me prescriptions for pain but didn’t prescribe physical therapy or other alternatives.
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