Scoliosis surgery is often used as a last-minute resort to help treat a curvature of the spine.
It is estimated that scoliosis affects about two to three percent of the United States population, or six to nine million people. Although most scoliosis cases are diagnosed in children and adolescents, adults are also susceptible to the spinal condition. Scoliosis is diagnosed in individuals who have a curvature of the spine that is sideways by at least 10 degrees. Unfortunately, we do not know exactly why scoliosis occurs, only that is can develop in infancy, adolescence, or later in life.
If you’ve been diagnosed with scoliosis, the first step is learning how to properly manage it. In many cases, no treatment is necessary, and the spine can correct itself in time or with the help of bracing. However, others require a more rigorous treatment plan that often includes scoliosis surgery. Perhaps the most common type of surgical scoliosis treatment is a spinal fusion, which uses a combination of instruments to carefully move the spine back into normal alignment.
When is Scoliosis Surgery Recommended?
Scoliosis in children is the single most common type of spinal deformity. It is believed that more than 133,000 children go to the hospital every year because of scoliosis, 17,500 of which are emergency room visits. Even though that it is the case, scoliosis surgery is considered a last resort and is only recommended for children with spinal curves that exceed 45 degrees.
Some other considerations for surgery as a scoliosis treatment include:
- Is your spine maturing or growing?
- Where is the location of the curve in your spine?
- Is there a high chance that the curve is going to get worse?
- How does the curvature of your spine affect your overall quality of life?
These are just a few questions that should be answered before moving forward with scoliosis surgery. We encourage you to discuss your case with Dr. Atwater and ensure you understand the benefits and risks of surgery for scoliosis in children and adults.
What to Expect
If Dr. Atwater and your medical team have decided that scoliosis surgery is the best form of treatment for your condition, there are a handful of things you should expect. Again, surgery is only recommended for severe cases of scoliosis where the curves are at least 45 degrees and are not responding to bracing or other management solutions.
What you can expect from scoliosis surgery will depend on the technique used, the patient’s age and medical history, and the exact curvature of the spine. The two different options for scoliosis surgery are:
- Posterior spinal fusion
- Anterior spinal fusion
Below, we will go over each method in more detail. If you have any questions, please contact an orthopedic doctor at OSA. We are here to answer any questions you may have and help ensure the right treatment path is taken. Scoliosis can be a frustrating condition, especially for adolescents. Here is information on how posterior and anterior spinal fusion for scoliosis are performed.
Posterior Spinal Fusion
Most spinal fusions for scoliosis treatment are done with the posterior approach. When the vertebrae are fused using the posterior surgical method, Dr. Atwater will begin by exposing the affected area of the spine by entering through the back. This type of scoliosis surgery can be used to address problems with any of the following parts of the spine:
Once Dr. Atwater has made the incision in the back, he will position screws and rods in the bone. Depending on the patient, the health of the spine, and any other existing conditions (such as spinal stenosis), either a partial or complete laminectomy may also be required.
After the spine has been stabilized, Dr. Atwater inserts a bone graft to support the procedure and encourage the vertebrae to join.
Anterior Spinal Fusion
If the anterior approach is preferred, the surgeon will enter through the chest walls, moving ribs to get to the spine, deflating the lungs, and making an incision on either side of the chest. This method is preferred if the patient needs added stability.
Other reasons a spinal fusion may be performed using the anterior method include:
- To provide direct access to damaged discs
- To avoid having to undergo multiple surgeries in the same area (for patients who have already had a spinal fusion using the posterior method)
- To add swayback to the spine
- To speed up the recovery process
Patients who undergo an anterior spinal fusion may need to remain in the hospital for one to three days following the procedure. A common type of back surgery, the anterior approach is also used to correct a number of low back conditions.
Recovery from Scoliosis Surgery
Many patients who undergo scoliosis surgery will be back to work and school within two to four weeks. In the best-case scenario, the patient will be nearly 100 percent back to their normal daily activities in a matter of months. To ensure you make a full recovery, it is imperative that you follow the at-home care instructions, especially for the first two months.
During this time, there are numerous precautions that should be taken while the spine heals from scoliosis surgery:
- No bending at the back (bending at the knees and hips is OK, with your surgeon’s prior approval)
- No lifting of items that weigh more than 8 pounds
- No twisting of the spine
If you adhere to the above, your recovery process should be smooth. And in about 10 months following the procedure, many people have been able to perform more laborious activities such as basketball, skiing, gymnastics, and other sports.
Our doctors at OSA can assess your condition and determine if one of the above spinal fusion options are right for you. If you or your child are suffering from this common curvature of the spine and would like to learn more about scoliosis treatment options, including surgery, please contact Ortho Spine America today.