Scoliosis is a sideways curvature of the spine that’s often treated with a specially designed brace. This is an effective treatment for many people with this condition, particularly children who begin wearing corrective braces until the point when bones stop growing. For times when scoliosis is getting worse or the sideways curvature is severe, surgery may be discussed. This can also happen if bracing is either not effective or not feasible for a patient. There are several options available with surgery for scoliosis.
Fusion Surgery for Scoliosis
Fusion surgery permanently joins or “fuses” adjacent vertebrae. This is done with graft material to allow bone tissue to grow in a way that creates a solid area of spinal bone. Special hardware that typically includes rods, screws, and wires or hooks is also used to maintain spinal stability until the graft material becomes solid bone.
With this type of surgery, there will be some limited mobility within the area of the spine that’s fused. However, advances in technology have made fusion surgery an increasingly effective way to correct spinal curvature problems.
Also, there is often an effort to fuse as few vertebrae as possible during surgery. This could result in a less noticeable impact on the ability to bend and make some other common spine-related movements.
Surgically Inserted Growing Systems
If scoliosis is rapidly progressing when a patient is still young, the type of surgery that may be recommended involves the creation of a growing system. With a growing system, rods are used to anchor the spine. If this is done when a child still has a developing spine, the curvature may be maintained or even improved.
If a growing system is used, additional surgery will be necessary every 6-12 months. The reason for doing this is to adjust the length of the rods to account for the natural growth of the spine. However, fusion surgery is still usually performed when a child reaches full skeletal maturity. The reason for waiting is to make sure there is enough room for internal organs to develop.
The purpose of the growing system is to serve as a type of guide to the spine as it grows and develops. In some cases, the abnormal curvature may be corrected enough so that fusion surgery isn’t absolutely necessary or recommended. Other times, preventing the curvature from worsening can make fusion surgery less complicated if it is necessary.
What Are the Goals with Scoliosis Surgery?
With any approach to surgically treating or managing scoliosis, there are specific goals a medical professional that performs this type of surgery usually has for patients. These include:
• Stopping the progression of the curve: At a minimum, any scoliosis procedure you consider should be planned with the intent of trying to stop the curvature from getting worse.
• Reducing the severity of the deformity: With a severe sideways curvature, you may have difficult standing up straight or making some daily movements without pain. This is why another common scoliosis surgery goal is to restore the spine’s natural curvature as much as possible.
• Retaining lower body/trunk balance: Changing the position of your spine can also have an effect on your lower body and trunk. For this reason, an effort is made to restore spinal alignment while also keeping the hips and legs as even and properly aligned as possible.
Fusionless Surgery Options for scoliosis
The idea of treating scoliosis surgically without a fusion procedure is based on similar techniques that were once routinely done to help children with leg heights that weren’t equal. Surgery involves creating pressure on the affected part of the spine, usually along the outside of the abnormal curve.
What this does is create a situation where growth is slowed down on the outer part of the curve while the inner side grows normally. Over time, the spine will become straighter because of the way pressure is applied. There are different methods that may be used to surgically accomplish this goal.
One possibility is to use a vertebral tethering system that works with a cord that’s pulled tight to create the desired pressure. The main benefit of this method is not losing any spinal mobility.
The first step in determining if surgery for scoliosis is right for you or your child is to get an accurate assessment of the condition. This will also allow you to get a better understanding of what treatment options are available, including both surgical and non-surgical solutions. We’re here to help. Call us today at 205-637-1363 to schedule an appointment.
