Scoliosis - Surgery

Highlights	Symptoms	Surgery
Introduction	Diagnosis	Treatment for Adult Scoliosis
Causes	Treatment	Resources
Risk Factors	Managing Scoliosis	References
Prognosis	Braces

Surgery

The goals of scoliosis surgery are threefold:

Straighten the spine as much as possible in a safe manner.
Balance the torso and pelvic areas.
Maintain correction.

These goals are accomplished in a two-component process:

By fusing (joining together) the vertebrae along the curve.
By supporting these fused bones with instrumentation (steel rods, hooks, and other devices) attached to the spine.

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Many surgical variations exist using different instruments, procedures, and surgical approaches. All of the operations require meticulous skill. In most cases, success depends less on the type of operation than on the skill and experience of the surgeon. The cause of scoliosis often determines the type of procedure. Parents of patients or adult patients should not be shy in asking the surgeon and hospital about their experience with the specific procedures being considered.

Surgical Candidates

Surgery is usually recommended for the following children and adolescents with idiopathic scoliosis:

All young people whose curve exceeds 50 degrees.
Growing children whose curve has gone beyond 40 degrees. (There is still some debate, however, about whether all children with curves of 40 degrees should have surgery.)
Older children who have surgery tend to experience improved well being from the changes in their appearance, even if they have no actual improved physical functioning. Surgery may be required for the following children at as early an age as possible.
Those whose scoliosis is due to inborn abnormalities. (The younger they are when surgery is performed the better their chances for success.)
Children with multiple physical handicaps.

It should be noted that procedures will differ depending on whether a child has idiopathic scoliosis or scoliosis due to muscle and nerve disorders (such as muscular dystrophy or cerebral palsy). In the latter cases, children also need a team approach to reduce their risks for serious complications.

Preoperative Care

Before the operation, a complete physical examination is conducted to determine leg lengths, muscle strength, lung function, and any postural abnormalities. The patient is trained in deep breathing and effective coughing to avoid lung congestion after the operation. The patient should also be trained in turning over in bed in a single movement (called log-rolling) before the operation. Psychologic intervention using cognitive-behavioral methods that help young patients cope may be very helpful in reducing anxiety and pain after surgery.