Verified By: Dr. Akhil Tawari (MBBS, MS (Orthopedics), DNB (Orthopedics), and D-Ortho)
What Is Scoliosis?
Scoliosis is a type of abnormality of the spine in humans wherein the spine bends in one direction causing loss of alignment. The curve may be in the shape of a C or an S. Scoliosis is a disease that starts to show effects from early teenage, however, there are not any major visible scoliosis symptoms.
There are two major types of scoliosis namely Degenerative Scoliosis and Idiopathic Scoliosis. The visible Scoliosis symptoms include the uneven fitting of clothing or sideways curvature of the body, change in the way of walking and hip alignment, difficulty in breathing, pain in the back, cardiovascular problems, and much more.
The Scoliosis condition, if diagnosed early can be treated by the wearing of spinal braces so that the curve does not progress into something else. However, if the spinal curvature cannot be controlled with a body brace, Scoliosis spine surgery is prescribed. The aim of the scoliosis surgery is to help to stop the curve from progressing any further.
What are the Types of Scoliosis Surgery?
There are three common surgical options for Scoliosis surgery:
- Spinal Fusion Surgery: This procedure is also known as Scoliosis Fusion and involves the fusion of a few vertebrae so that they cannot bend anymore and can now grow together as one vertebra. Various instruments like rods, wires, and hooks are used to achieve this. This is one of the most effective surgical procedures for scoliosis.
- Growing System Spine Surgery: This surgery is also known as Growth Rod Surgery and is mainly performed in growing children whose spine is still developing. A few rods are fixed into the spine by a spine surgeon to correct the curve as the child progresses to develop. This surgical approach has to be repeated every 6 to 8 months. Once the child has matured completely, he undergoes spinal fusion.
- Fusion less Spinal Surgery: This method is based on the theory that if constant pressure is applied to the spine, it will start growing slower and much denser. This major surgery involves attaching screws to the outer curvature and then pulling them with a string in order to straighten the spine.
The degree of the condition and the location of the curve are two very important things to keep in mind before undergoing a surgery. Scoliosis surgery is determined based on the age and whether the spine is still in the growing period or not.
How is Scoliosis Surgery Performed?
Surgery is usually reserved for people with curves greater than 40 degrees. Scoliosis correction surgery is done using pedicle screws and rods.
- Step 1: The pedicle screws are placed into the individual vertebrae and a contoured rod is placed and the screws are connected to it.
- Step 2: The spine is fused using autograft and allograft bone available from the bone bank. The skin is closed using absorbable sutures so that the cosmetic appeal is maintained.
- Step 3: The operation lasts 4–8 hours and they may have to remain in the hospital for a week to 10 days.
- Step 4: They will need to return to the hospital every 6 months to have the rods lengthened.
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What are the Alternatives for Scoliosis Surgery?
If the spine is still growing, then it is not a good idea to go for the surgery. In such cases, there are treatment options to be considered for scoliosis. The treatment options for scoliosis are reserved for children whose curves are lesser than 40 degrees. The options are as below:
1. Casting:
Casting instead of bracing is sometimes used for infantile scoliosis to help the infant’s spine to go back to its normal position as it grows. This can be done with a cast made of plaster of Paris.
The cast is attached to the outside of the patient’s body and will be worn at all times. Because the infant is growing rapidly, the cast is changed regularly.
2. Braces:
In case of a moderate scoliosis where the bones are still growing a brace is recommended. This will prevent further curvature, but will not cure or reverse it. Braces are usually worn all the time, even at night. The more hours per day the patient wears the brace, the more effective it tends to be. When the bones stop growing, braces are no longer used.
Braces won’t straighten the spine, but they can prevent the curvature from increasing. This method of treatment is more effective for cases that are detected early. The aim of bracing is to reduce the risk of the condition getting worse. There are two types of braces:
- Underarm brace / Thoracolumbosacral orthosis (TLSO) – the TLSO is made of plastic and it is designed to fit neatly around the body. It is usually used to treat lower spine curves and it is not usually visible under clothing.
- Milwaukee brace – This brace starts at the neck and covers the entire torso, with the exception of the legs and arms. This type of brace is only used when the TLSO is not possible or not effective.
3. Chiropractic treatment:
It is important to visit a chiropractor who specializes in scoliosis. Receiving chiropractic treatment from a non-specialist can make symptoms worse.
Chiropractic treatment can improve the quality of life but it is not a cure. Although it can help people with scoliosis feel better, it does not resolve the curvature of the spine.
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Plan for Scoliosis surgery In India
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Frequently Asked Questions:
What is Scoliosis Treatment?
Scoliosis is a type of abnormality of the spine in which the spine bends in one direction causing loss of alignment. The curve may be in the shape of a C or an S. Scoliosis is a disease that starts to show effects from early teenage, however, there are not any major visible scoliosis symptoms.
What are the types of Scoliosis Conditions?
There are two major types of scoliosis namely Degenerative Scoliosis and Idiopathic Scoliosis. The visible Scoliosis symptoms include the uneven fitting of clothing or sideways curvature of the body, change in the way of walking and hip alignment, difficulty in breathing, pain in the back, cardiovascular problems, and much more.
How do you correct Scoliosis?
Scoliosis, if diagnosed early, can be treated by wearing braces so that the curve does not progress into something else. However, if the curve cannot be controlled with a brace, surgery is prescribed. So the basic aim of the scoliosis surgery is to help reduce the curve, stop the curve from progressing any further and also help the person maintain their balance.
Does spinal fusion help Scoliosis Correction ?
Spinal fusion is very successful in stopping the curve from growing. This procedure involves a fusion of a few vertebrae together so that these cannot bend anymore and grow together as one vertebra. Various instruments like rods, wires, and hooks are used to achieve this. This is one of the most effective surgical procedure for Scoliosis.
What are the Side Effects of Scoliosis Treatment?
There are a few scoliosis symptoms and side effects associated with the Scoliosis Surgery that includes:
- Back pain still remains
- No improvement in the breathing problems.
- Scarring
- Damage to the nerves or muscles near the spine
- Infections
- Failure of the procedure
- Attachment of wrong implants
- Pain
- Bleeding in the operated area.
What tests to determine the exact degree of curve in the Spine?
X-ray in standing position to determine the exact degree of curve in the spine.
What to expect after Scoliosis Surgery?
After the surgery, the patient is left to recover for about two weeks or more. This depends on how big the surgery was and how much area had to be opened up to be corrected. The alignment improves dramatically after the surgery. However, it might take several months for the patient to restart their daily activities. The patients might also feel that their range of motion has decreased; this is normal and happens to all the people with Scoliosis Surgery.