Scoliosis surgery: what you need to know

Scoliosis is a condition that causes an atypical curvature of the spine. It is usually diagnosed during childhood or adolescence and can cause back pain, balance or posture problems, and breathing difficulties.

Scoliosis surgery is not always needed immediately because there are different levels of the disease.

This article will give you more information on when scoliosis is considered serious enough to require surgery, how surgery is performed, and what you can expect during recovery.

Whether or not to treat scoliosis with surgery is a decision you and your doctor should make.

Generally, medical professionals do not consider surgery for scoliosis until a person’s pain or disability has worsened. This is often determined by a curvature of the spine of 40 degrees or more.

Even if the curve in your spine has not reached this level, your doctor may decide that you need surgery if you have other related problems. These concerns may include difficulty breathing or if your scoliosis seems to be progressing rapidly.

Spinal fusion is the most common method of surgically correcting scoliosis. The purpose of this surgery is to realign curved areas of the spine, by fusing metal rods or pieces of bone together to form a new, straighter and stronger section of spine.

A surgeon will perform the surgery while you are under general anesthesia. These are incisions that expose the spine, allowing the surgeon to insert various implants into the body.

Impacts can include:

New forms of scoliosis surgery

Some newer surgical options do not require fusion. Instead, they use other techniques to straighten the spine and prevent further curvature.

These options include:

  • Spinal Tethering Surgery (VBT): In this procedure, a surgeon attaches metal anchors to the vertebrae on the side of the spine that curves outward. These anchors attach to a flexible lanyard to gradually straighten the back. Over time, the goal is for the brace to return the spine to the correct position. This technique is often less invasive and provides faster recovery than spinal fusion. This option is also sometimes preferred for younger people who have not yet reached full height, as it leaves room for future growth.
  • ApiFix and internal bracing technique: This treatment uses an internal bracing system attached to the spine by two screws at the top of the device and a single screw at the bottom. ApiFix has a faster recovery time than the other two methods, and your healthcare professional can adjust the brace system for additional correction over time.

Although alternative surgeries may offer more choices when it comes to accommodating the growth of children or adolescents undergoing surgery for scoliosis, more complications may occur with these procedures than with just one. spinal fusion.

Any type of surgery carries some risk, especially when general anesthesia is used during the procedure. Invasive surgeries like spinal fusion can also carry a risk of infection or bleeding.

Some complications and risks specific to scoliosis surgery may include things like:

  • neurological or nerve damage
  • muscle or dural tears
  • vision loss
  • positioning problems
  • blood clots
  • implant malfunctions or problems
  • breathing or breathing problems
  • digestive or gastrointestinal symptoms

Overall, many experts in the field note that scoliosis surgery – and spinal fusion in particular – has been shown to be very effective and safe.

Even in 2009, this report from the Department of Orthopedics and Sports Medicine at the University of Washington stated that “the success rate of stable fusion and correction of spinal deformity is very high in experienced hands . The average curve correction is about 70% and the likelihood of complications has been about 2% to 3% overall. »

This success rate has improved with advances in techniques and medical care, according to 2012 research.

For children born with congenital spinal differences such as scoliosis, surgery can be done as early as 18 months. The decision of when to have surgery will depend on factors such as:

  • the degree of scoliosis
  • what other complications develop
  • how fast the curvature increases

Different materials can be used depending on the child’s growth and development situation.

The cost of spine surgery will depend on where you live, the type of health insurance coverage you have, and any other conditions or complications that may be involved in your recovery.

As with many other health care costs, the price has skyrocketed over the past 25 years for spine surgery to correct adolescent idiopathic scoliosis. In 2012, this cost was about $177,000, compared to about $55,000 in 1997, according to research published in 2017.

Steps taken to prevent complications and speed up your discharge from hospital could result in savings of up to 21%, according to the same researchers.

Bracing is the common non-surgical treatment for scoliosis. Braces typically work for several months or longer and can be made of hard or soft materials.

Generally, people who are candidates for brace therapy are those who have:

  • a curvature between 20 degrees and 40 degrees
  • a small but gradual curve
  • a wider curve but a lot of vertebral growth still needs to be done

In most cases, you can see the effects of spinal fusion surgery immediately after surgery. The same is true for other surgical methods, although tethering devices may take longer to produce the full effect.

Despite the outward appearance that a curvature is “fixed” after spinal fusion surgery, it can actually take 1-2 years after surgery for the implants and spine bones to fully fuse together.

The spinal fusion surgery itself can take around 4-6 hours and requires a 3-4 day hospitalization. Although complications are possible and recovery takes time, people who undergo spinal fusion surgery generally have a better quality of life after the procedure.

Spinal fusion surgery is the primary surgical treatment for most people with severe scoliosis. Some other methods may facilitate future growth, but these options may carry the risk of additional complications.

Non-surgical options are available, but generally for less severe cases of scoliosis.

If you or your child have been diagnosed with scoliosis, discuss with your healthcare professional the best way to monitor the degree of curvature of the spine and the progression of the disease. Surgery is usually only recommended for more severe curves, such as curves measuring 40 degrees or more.

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