The spine is the backbone of the body. It naturally curves a little. This allows us to walk, move and balance ourselves properly. But some people have a spine that curves too much to one side. This condition is called scoliosis. In most cases, especially in children and adolescents, the cause of scoliosis is unknown and scoliosis is referred as idiopathic scoliosis.
Scoliosis usually has no symptoms. In severe cases, the body looks asymmetrical with uneven hips or shoulders. Severe scoliosis may also cause backache and could contribute to other health problems.
To diagnose scoliosis your doctor will do a physical examination. The doctor will also order some diagnostic tests such as X-rays, a Computed Tomography (CT) scan and/or Magnetic Resonance Imaging (MRI) to determine the actual curving of the spine. If your doctor considers that your curve is mild they may prescribe back braces to prevent further curving. However, if the curve is more than 45 degrees, your doctor may recommend corrective spinal surgery.
The goal of scoliosis surgery is to both reduce the abnormal curve in the spine and to prevent it from progressing further and getting worse. To achieve this, a spinal fusion is performed to fuse the vertebrae, in the curve to be corrected. This involves placing bone graft or bone graft substitute in the intervertebral space between the two vertebrae. Instrumentation such as rods and screws are also used to realign and stabilize the vertebrae until the graft heals and fuses the two vertebrae together.
There are several approaches for scoliosis surgery. The choice of approach depends on a number of factors such as the type of scoliosis, location of the curvature of spine, ease of approach to the area of the curve and the preference of the surgeon.
Anterior-posterior approach is also called front and back spinal surgery. This approach is usually recommended for very severe and stiff curves. Sometimes, it is also used to correct previous failed attempts. In this approach, the spine is first accessed from the front or anterior side of the body through an incision on the side followed by an incision on the back (posterior side of the body).
An anterior-posterior scoliosis surgery is performed under general anesthesia.
The whole procedure usually takes several hours.
The spine looks much straighter soon after the surgery but some curve will still be there. Spinal bones take a minimum 3 months to fuse together. However, complete fusion usually takes one to two years.
Scoliosis surgery is a major surgery. All attempts are made to reduce the chances of any risks or complications of this surgery. Still, complications may occur in a few patients. Complications of scoliosis surgery may include paraplegia, excessive blood loss, infection and failure of the spine to fuse. Rarely, cerebrospinal fluid leakage or instrumentation problem such as breaking of rods or dislodging of hooks and screws may also occur.