McHughBrian J. McHugh, MD, is a board-eligible neurosurgeon.  He specializes in surgical treatments for spinal deformities in children and adults. 

Recently, I saw a patient in her 70s who came into the office leaning on her walker. She was bent almost at a 45-degree angle. After six spine surgeries to correct a series of back problems, most of her spine was fused and covered with metal hardware — yet she couldn’t even stand up straight.

The patient told me she’d visited several major treatment centers, and they all told her there was nothing more that could be done. She wasn’t ready to accept that conclusion, however ­– and neither was I. Inova is one of a handful of hospitals in the country that regularly tackles these complicated cases.

My colleagues and I performed surgery to realign this patient’s spine. A few days ago she walked into my office, standing straight as an arrow and talking about her plans to finally ride her horse again.

shutterstock_210067249Common Spine Deformities

Spinal deformities develop for a variety of reasons. The most common causes include:

  • Congenital disorders. A number of congenital disorders (that is, disorders present from birth) can cause deformities of the spine. One example is Marfan syndrome, a genetic disorder that affects the body’s connective tissue.
  • Adolescent idiopathic scoliosis (AIS). Scoliosis causes the spine to curve sideways. AIS appears in children between 10 and 18 years old, and the exact cause is unknown. Fortunately, most cases can be treated in childhood without surgery. Occasionally, we see adults who were diagnosed with AIS as kids and end up needing surgery as adults after aging and arthritis have added to their back problems.
  • Adult degenerative scoliosis. Also known as de novo scoliosis, this is an age-related curvature of the spine caused by arthritis and degeneration of the shock-absorbing discs between the bones of the spine.
  • Iatrogenic spinal deformity. That’s a long way of describing patients who have had one or more surgeries to correct back problems in the past but are still experiencing alignment problems and pain.

Treating Back Problems

Whenever we can, we prefer to treat back problems without surgery. That often involves physical therapy or injections to ease the pain of a pinched nerve. When that’s not enough, though, many patients find relief through spine surgery.

In the last decade, researchers have made a lot of progress in understanding complex spinal deformities. The spine changes normally as we age, and we now have increased knowledge of what a well-aligned spine looks like at every age. That means we can help more patients, including those like my horse-loving patient, who have already been through unsuccessful operations.

Unfortunately, such patients are frequently told there’s nothing more surgeons can do. In fact, we can help many of these people function normally again. It’s so striking to see a patient who initially comes in hunched over and walking with a cane that returns for a follow-up visit standing tall.

If you’re suffering from back pain, visit the Inova Spine Program to learn more about how our team can help you find relief.


  1. Marguerite on December 26, 2016 at 1:47 pm

    Please help me. This sounds encouraging. I’m at the end of my rope. I called to make an appointment. I cannot stand or sit without excrutiating pain. Nothing has worked…injections failed, meds failed, PT making it worse, not better.

    • InovaNewsroom on December 27, 2016 at 8:51 am

      If you would like someone to reach out, please contact us at, and provide your phone number. We will have someone from the doctor’s office contact you.

Leave a Comment