According to a press release from the royal family, "the low back feature on the dress was at the specific request of Princess Eugenie who had surgery aged 12 to correct scoliosis." Princess Eugenie has been an outspoken advocate for scoliosis, sharing photos of her X-rays on Instagram and supporting hospital programs, but this very public display of her scar was moving for many people with scoliosis.
In 2002, when Eugenie was just 12 years old, she was diagnosed with scoliosis, defined as curvature of the spine greater than 10 degrees, and told that she would need corrective surgery. It's unclear exactly what causes scoliosis, but it tends to be hereditary, according to the Mayo Clinic. Often people are screened for scoliosis around the age that Eugenie was diagnosed, or at the onset of puberty, according to the American Association Of Neurological Surgeons (AANS). An estimated six to nine million people in the United States have scoliosis, and interestingly, scoliosis seems to progress faster in girls.
Depending on the severity of the curve, and the age of the person, scoliosis can require a brace or surgical intervention to prevent it from getting worse, per the American Academy of Orthopedic Surgeons (AAOS). Approximately 38,000 patients will need to undergo spinal fusion surgery, the procedure used to correct scoliosis, according to the AANS.
"This was, of course, a scary prospect for a 12-year-old," Eugenie told the Royal National Orthopedic Hospital, where she had her surgery. "I can still vividly remember how nervous I felt in the days and weeks before the operation." The corrective operation took eight hours, during which surgeons inserted eight-inch titanium rods on each side of her spine and screws at the top of her neck. "After three days in intensive care, I spent a week on a ward and six days in a wheelchair, but I was walking again after that."
People with scoliosis who were watching the royal wedding on Twitter commented that seeing Eugenie's scar made them feel "empowered," "proud," and "emotional." But to Eugenie, displaying her scar was simply a way to "stand up for young people who also go through this" and show that you can redefine beauty standards, she previously told ITV's This Morning. "I think you can change the way beauty is," she said. "You can show people your scars, and I think it's really special to stand up for that."