Surgery for adolescents with
scoliosis is only recommended when their curves are greater than 40 to 45
degrees and continuing to progress, and for most patients with curves that are
greater than 50 degrees.
Unlike back braces, which do not
correct spinal curves already present, surgery can correct curvature by about
50%. Furthermore, surgery prevents further progression of the curve.
There are several approaches to
scoliosis surgery, but all use modern instrumentation systems in which hooks
and screws are applied to the spine to anchor long rods. The rods are then used
to reduce and hold the spine while bone that is added fuses together with
existing bone.
Once the bone fuses, the spine
does not move and the curve cannot progress. The rods are used as a temporary
splint to hold the spine in place while the bone fuses together, and after the
spine is fused, the bone (not the rods) holds the spine in place. However, the
rods are generally not removed since this is a large surgery and it is not
necessary to remove them. Occasionally a rod can irritate the soft tissue
around the spine, and if this happens the rod can be removed.
Two
Approaches to Scoliosis Surgery
There are two general approaches
to the scoliosis surgery - a posterior approach (from the back of the spine)
and an anterior approach (from the front of the spine). Specific surgery is
recommended based on the type and location of the curve.
This approach to scoliosis surgery is done through
a long incision on the back of the spine (the incision goes the entire length
of the thoracic spine).
·
After
making the incision, the muscles are stripped off the spine to allow the
surgeon access to the bony elements in the spine
·
The spine
is then instrumented (screws are inserted) and the rods are used to reduce the
amount of the curvature
·
Bone is
then added (either the patient's own bone, taken from the patient's hip, or
cadaver bone), inciting a reaction in which the bones in the spine begin fusing
together
·
The bones
continue to fuse after surgery is completed. The fusion process usually takes
about 3 to 6 months, and can continue for up to 12 months
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For patients who have a severe deformity and/or
those who have a very rigid curvature, another procedure may be required prior
to this surgery. A surgeon may recommend an anterior release of
the disc space (removal of the disc from the front), which involves approaching
the front of the spine either through an open incision or with a scope
(thoracoscopic technique) and releasing the disc space.
After the discs at the
appropriate levels of the spine have been removed, bone (either the patient's
own bone and/or cadaver bone) is added to the disc space to allow it to fuse
together.
Removing the discs allows for a
better reduction of the spine and also results in a better fusion. These two
factors are especially important if the patient is a young child (10 to 12
years old) and has a lot of skeletal growth left.
Without the anterior release
procedure, the anterior column (the part of the spine facing the front of the
body) can continue to grow, eventually twisting around the fused, non-growing
posterior spinal column, forming a new scoliosis curve (called "crankshafting").
Fusing the spine anteriorly prevents this process.
2. Scoliosis
Surgery from the Front (Anterior Surgical Approach)
For curves that are mainly at the
thoracolumbar junction (T12-L1), the scoliosis surgery can be done entirely as
an anterior approach.
·
This
approach to scoliosis surgery requires an open incision and the removal of a
rib (usually on the left side). Through this approach, the diaphragm can be
released from the chest wall and spine, and excellent exposure can be obtained
for the thoracic and lumbar spinal vertebral bodies.
·
The discs
are removed to loosen up the spine.
·
Screws
are placed in the vertebral bodies and rods are put in place to reduce the
curvature.
·
Bone is
added to the disc space (either the patient’s own bone, taken from the
patient's hip, or cadaver bone), to allow the spine to begin to fuse together.
·
This
fusion process usually takes about 3 to 6 months, and can continue for up to 12
months.
If this surgery is applicable
because of the type of curvature, the anterior approach to scoliosis surgery
has several advantages over the posterior approach.
·
Not as
many lumbar vertebral bodies will need to be fused and some additional motion
segments can be preserved
·
Saving
motion segments is especially important for lower back curves (lumbar spine),
because if the fusion goes below L3 there is a higher risk of later back pain
and arthritis
·
Saving
lumbar motion segments also helps prevent loading all the stress on just a few
motion segments
·
This
approach can sometimes allow for a better reduction of the curve and a more
favorable cosmetic result.
Our network hospitals have the most advanced spine surgery facilities. The spine surgeons here use minimally invasive and computer guided techniques in spine surgery. In a Minimally Invasive spine surgery the surgeon makes a few small incisions unlike the open surgery where a single large incision is made. Minimally Invasive spine surgery has several important benefits for the patients. If you have been advised spine surgery your first choice should be the latest minimally invasive technique developed by our world best hospitals in India. Most advanced Technology like Intra Operative MRI, Brain Suite and Computer Assisted Navigation System are deployed by highly trained surgeons for accurate and safe Spine Surgeries through a small incision.
Why should you choose to get Indian hospitals offer the best spinal surgery treatment in India at affordable prices. MedWorld india associated best spine surgery hospitals in India have the latest technology and infrastructure to offer the most advanced spine surgery at low cost.
Salient features of these hospitals are:
- Comprehensive management of spine disorder from birth defects to degeneration of tumor and trauma.
- Dedicated team of International trained and vastly experienced Spine Surgeons, Rheumatologists, Neurologist, Physicians and Physiotherapist.
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- Latest Generation Diagnostic and Imaging facilities including dynamic digital X rays, Spiral CT scanning , MRI and Electrophysiology unit all under one roof.
- Physiotherapy and Rehabilitation by experts after the surgery help you regain functional abilities quickly helping in vastly improved overall results.
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Please scan and email your medical reports to us at care@medworldindia.com and we shall get you a Free Medical Opinion from India’s Best Doctors.Call Us : +91-9811058159Mail Us : care@medworldindia.com
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