Scoliosis drastically affecting a patient’s posture, health, or quality of life may require surgery. Several surgical options exist to correct this abnormal curvature of the spine and include spinal fusions and the placement of metal rods to the spine. Depending on the patient’s age, an Orthopedic surgeon may employ variations of both procedures, because spinal fusion results in the termination of bone growth in the spine.
What is it?
Although there are several ways to perform Scoliosis surgery, almost all of these procedures involve anchoring the spine with long metal rods using hooks and screws. The rods, anchoring the spine, enable surgeons to correct the abnormal curvature of the spine by approximately 50% while simultaneously preventing spinal curve regression. As with any major surgical procedure, one must carefully weigh the costs, benefits and risks of scoliosis surgery. This is especially true for adolescents with scoliosis since surgery requires spinal fusions, which prevent further spinal growth. Younger patients generally undergo surgery only when their spinal curve deviates from normal by more than 45 to 50 degrees and the disease continues to progress.
What should I do to prepare?
Patients may need to donate blood before surgery so blood transfusions can occur during the operation, if necessary. Surgeons will ask patients to stop taking NSAID medications for two to three weeks before surgery. Pre-admission testing, physical examinations, and meetings with physicians take place several weeks before the scheduled procedure. After surgery, patients should plan for an extended recovery time, because a full recovery usually takes several months and spinal fusions may take a year to fuse completely. Patients should confer with family, friends, and employers to ensure they are prepared to suspend and then resume your normal activities.
What happens during the process?
Depending on the severity of the spine curve, the surgeon may elect to perform surgery posteriorly or anteriorly. Patients will be under general anesthesia for either procedure. Posterior surgery, or performing the operation from the back, involves stripping muscle away to expose the vertebrae, the bony elements of the spine. Next, inserting rods and screws into the spine occurs to anchor, correct the abnormal curvature, and prevent the spine from moving. Then, bone grafts from the patient, or a donor are implanted to initiate vertebral fusion. The anterior approach, or performing the operation from the front, is performed when scoliosis occurs in the thoracolumbar region of the spine. This method involves the removal of a rib and then moving discs between the vertebrae to loosen the spine. Spinal fusion occurs in a similar fashion to the posterior approach.
What are the risks and potential complications?
Scoliosis surgery is a major surgery that comes with a number of risks. One of the most severe complications is paraplegia. This is very rare, but it is a devastating complication. Fortunately, the spinal cord can be monitored in a variety of ways during the surgery to prevent unintended damage. Another risk involved with this procedure is that the strain on unfused vertebrae can cause pain and discomfort. Other possible complications and risks are postoperative pain, excessive bleeding or infection, curve progression or increased torso deformity, failure of the spine to fuse, and cerebrospinal fluid leak (very rare).
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