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Scoliosis surgery is an extensive medical procedure used to correct a severe curvature of the spine. Generally conducted on children and adolescents, the surgery is only pursued in cases where the curvature of an individual's spine exceeds 35 degrees. There are significant risks associated with scoliosis surgery, and these should be discussed with a qualified health care provider prior to considering surgery.
The degree of an individual's spinal curvature directly impacts his or her treatment options. In cases of idiopathic scoliosis, or that with no known cause, in which an individual's spinal curvature is less than 35 degrees, bracing is usually successful. Surgery is usually conducted only on individuals with congenital or neuromuscular scoliosis to prevent further progression of the curve and complications. The progression of scoliosis is such that, as the spine rotates, the chest cavity starts to compress, leaving limited space for respiratory function. If a severe curve is left untreated, further deformity and respiratory complications can result.
Surgical curvature correction requires incisions to be made along the patient's spine, also known as a posterior approach. In cases of severe spinal curvature, incisions are made in the abdomen and below the ribs to aid with placement of instrumentation, known as an anterior approach. The difference between posterior and anterior approaches lies with extent of fusion required and postoperative mobility.
During the posterior approach, after incisions are made and the spine is exposed, two metal rods are placed along either side of the spine. The rods are then anchored to the spine with either screws or hooks to reduce the spinal curvature. Anchoring the spine is essential to providing curvature correction and proper spinal support. Vertebral disks are removed and portions of bone are added along the spine which fuse together, providing further reinforcement.
The anterior approach involves the removal and fusion of fewer vertebrae and reduces stress on the lower back. Curvature reduction and minimal scarring are advantages associated with this surgical approach. A disadvantage of the anterior approach is its application is limited to the correction of certain types scoliotic curves excluding those that occur along the thoracic spine in the upper back.
Requiring hospitalization, the scoliosis surgery takes approximately six hours and is accompanied by a lengthy recovery process. Over the course of approximately a year, the patient's progress is closely monitored with periodic checkups, and his or her physical activity is strictly limited. Allowing appropriate time for the spinal fusion to heal, restrictions are lifted in three month increments. By the end of one year, the patient is usually able to resume a fully active lifestyle.
Following surgery, the patient's spine will be straighter and with no need for bracing. The development of complications associated with scoliosis surgery is rather significant. Complications can include nerve damage, infection, and excessive blood loss. Additional postoperative risks associated with scoliosis surgery include fusion failure, continued curvature progression, and the dislodging of the anchoring or rod breakage.