Scoliosis Surgery

Scoliosis Surgery

Scoliosis surgery is a treatment for scoliosis, a condition where the spine is tilted, rotated, or curved sideways in an "S" or "C" shape. This curvature is more than 10 degrees and can result from genetics, hormones, neurological issues, muscle diseases, or overuse. Scoliosis causes the body to lean to one side, affecting the balance and personality, potentially leading to breathing and neurological problems that impact quality of life. Scoliosis surgery aims to stop further spine curvature, straighten the spine, and create stability for a stronger and more balanced spine.

What causes scoliosis?

Scoliosis has several causes:

• Congenital scoliosis from fetal spine development issues during pregnancy. Detectable in childhood, when a single vertebra fuses on only one side or grows unevenly between the two sides (at least on one side, left or right).
• Neuromuscular scoliosis is a spinal deformity caused by neuromuscular conditions like cerebral palsy and neurological, hormonal, or spinal cord injury problems, which result in neurological and muscular system disorders such as trunk muscle imbalance and muscular dystrophy and lead to abnormal spinal curvature.
• Degenerative scoliosis is a spine deformity caused by age-related deterioration and spinal strain, resulting in the vertebral joints and intervertebral discs on both the left and right sides collapsing, becoming imbalanced with uneven curving. Degenerative scoliosis is most common in adults and the elderly.
• Idiopathic Scoliosis: Without a known cause, it's believed to have genetic links affecting multiple bodily systems. Typically noticed during adolescence, it progresses as the body grows, resulting in more twisted deformation accentuated by physical growth.

At what age can idiopathic scoliosis develop?

Idiopathic scoliosis can affect males and females without distinction across various age groups, from childhood to adolescence and adulthood. Females are eight times more likely than males to have scoliosis when they reach adolescence, and their bodies are fully grown. Scoliosis is classified according to age as follows:

• Infantile idiopathic scoliosis typically presents symptoms before the age of 3.
• Juvenile idiopathic scoliosis commonly presents symptoms between the ages of 4 and 10.
• Adolescent idiopathic scoliosis typically presents symptoms between 10 and 18 years of age.
• Adult idiopathic scoliosis is a spinal condition commonly observed in individuals aged 50 and above, often arising due to wear and tear from prolonged use. This condition frequently leads to associated health issues like vertebral compression fractures, herniated discs, or herniated nucleus pulposus, which manifest as symptoms including back pain, radiating back pain down the leg, numbness, weakness in the legs, and more.

What are the signs and symptoms of scoliosis?

The signs and symptoms of scoliosis can differ based on the underlying cause, the extent of the spine's curvature, and other joint-related conditions. To assess potential symptoms, individuals can undergo a simple test by standing with their legs together and bending horizontally while maintaining a 90-degree bend of their hips. If scoliosis is present, noticeable uneven curves on both sides of the back may become apparent, along with the following symptoms:

• Uneven shoulders at differing heights on both sides.
• Discrepancy in clavicle heights.
• Asymmetry of the shoulder blades.
• Off-center positioning of the head between the two pelvic sides.
• Misalignment of the spine.
• Unevenness in the back or chest on both sides.
• Body tilting to one side asymmetrically.
• One hip or pelvis side is higher than the other.
• Asymmetrical waistline on both sides.
• Legs asymmetry.
• Abnormal walking pattern (gait).

How is scoliosis diagnosed?

Orthopedists diagnose scoliosis through a comprehensive evaluation, including a physical examination to ascertain the Cobb angle. Additionally, radiographic imaging from both the anterior and posterior aspects of the body is employed to confirm the presence of the condition. Medical professionals can diagnose scoliosis through the utilization of the following approaches:

• X-ray of the complete spinal structure, encompassing the joints and cervical vertebrae, is employed to assess the extent of curvature (Cobb angle) and the underlying factors contributing to scoliosis. This diagnostic method aids in identifying potential causes such as internal injuries, fractures, bone deformities, or infections.
• CT scan (Computed Tomography scan) is a diagnostic procedure to analyze the structure of the spine and spinal cord, including assessment of the dimensions and configuration of the spinal cavity. Its purpose is to identify deviations from normalcy within the spine, such as degeneration, fractures, bone fractures, anomalies, or infections.
• MRI (Magnetic Imaging) examination is employed to scrutinize the composition of the spine and spinal cord, offering a detailed visual representation of the spinal cavity, lumbar spinal nerve roots, and any deviations within the spine. This imaging technique provides high-resolution images that aid in identifying abnormalities like degeneration, bone overgrowth, and deformities in the spine.

What are the guidelines for assessing scoliosis?

The orthopedist will evaluate the radiological images to confirm scoliosis using the following evaluation criteria:

• Evaluate spinal growth to see if the skeleton has reached full maturity.
• Assess the degree and severity of scoliosis symptoms affecting lifestyle. The more severe the scoliosis symptoms are, the greater the need for surgery.
• Examine the position of scoliosis with a curved spine in the thoracic position, which is more likely to develop spinal curvature than other positions.
• Assess age, as scoliosis can worsen with age, particularly in those who have had scoliosis since childhood before entering adolescence; they are more likely to have scoliosis than those whose symptoms began in adolescence or adulthood.

How is scoliosis treated?

Once scoliosis is confirmed, the orthopedist assesses factors like the Cobb angle degree, potential lifestyle complications, and the rate of progression. Treatment options are then determined based on these considerations. The available scoliosis treatment options include:

• Observation: Orthopedists advise this approach for individuals with scoliosis curves ranging from 20 to 25 degrees or those diagnosed during childhood and adolescence. Regular follow-up appointments every 4-6 months are advisable until spinal maturity and bone structure are no longer affected.
• Bracing: When the curvature falls between 25 and 40 degrees and skeletal maturity has not been attained, orthopedists might propose bracing. Wearing a brace for at least 16–23 hours daily is advised to achieve spinal alignment and stability. The orthopedist will schedule follow-up appointments until reaching skeletal maturity. Consistent adherence to wearing the brace can effectively diminish spine curvature and decelerate its progression.
• Scoliosis surgery: When the curvature exceeds 45 degrees or demonstrates a tendency for swift progression, orthopedists will suggest scoliosis surgery. This procedure aims to rectify the spinal curvature and preempt future scoliosis issues. Additionally, the specific surgical approach will be determined mainly by the configuration of the scoliosis.

How is scoliosis surgery performed?

Scoliosis surgery is decided upon by orthopedic surgeons when dealing with individuals having scoliosis characterized by a Cobb angle exceeding 45 degrees or demonstrating rapid progression. The goal is to correct the spinal curvature, enhance spine strength and stability, and forestall future scoliosis issues. The orthopedic surgeon will evaluate scoliosis surgery options based on the following surgical techniques:

• Posterior approach entails the insertion of a metal rod through the middle of the body, accompanied by screws to maintain spinal alignment, followed by a spinal fusion, using bone graft to solidify the spinal column's connection into a unified structure. Additionally, this technique addresses bone deformities and spinal torsion. The posterior approach is the most common surgery in contemporary practice.
• Anterior approach to spinal procedures employs endoscopic surgical methods and O-Arm technology. This technology assists in visualizing the internal anatomical structures in three dimensions, enhancing precision in locating the surgical site, conducting the procedure, and securing screws. Moreover, the anterior approach facilitates more precise screw placement, minimizes the chances of spinal cord interference, and diminishes the risk of surgical complications.
• Magnetic control growing rod (Magec rod) is a surgical method to address scoliosis in children aged 5 to 10. The procedure involves an orthopedist conducting endoscopic surgery with the assistance of O-Arm computerized navigation, which guides the insertion of a Magec Rod that can extend up to 10 cm and rotate in the desired direction. To achieve optimal outcome, the orthopedist will arrange appointments every 2-3 months to incrementally lengthen the Magec rod and stretch the bone by 3–7 mm per session without causing discomfort to encourage bone development, heighten bone growth potential, and effectively alleviate scoliosis symptoms. Additionally, as the child approaches adolescence, the orthopedist will coordinate a subsequent follow-up appointment for a bone fusion surgery.

How long does post-scoliosis surgery recovery take?

The recovery period following scoliosis surgery typically takes 2-4 weeks. The resumption of regular activities generally occurs within 4-6 months, contingent upon the severity of the scoliosis and the individual's physical resilience.
Scoliosis Surgery at MedPark Hospital

MedPark Orthopedics Center

At the helm of MedPark Orthopedics Center is a group of skilled orthopedic surgeons adept in performing scoliosis surgery across all age groups. They are experts in advanced endoscopic and minimally invasive surgery (MIS) techniques, characterized by small incisions, reduced discomfort, and minimal recovery duration. Leveraging AI medical technology, these experts ensure precision in surgical procedures, diminish the likelihood of complications, hasten the recovery process, and effectively address spinal curvature concerns.

MedPark Physical Medicine and Rehabilitation Center. Overseen by a dedicated team of rehabilitation physicians and physiotherapists with extensive experience and substantial expertise, the Center offers specialized care and guidance to individuals undergoing surgery, aiding in the efficient recovery of the skeletal, muscular, and joint systems following surgical procedures. Their systematic and comprehensive approach accelerates recuperation and fosters optimal physical fitness. The post-surgery care provided by MedPark facilitates age-appropriate growth, enhances bone and muscle robustness, and empowers scoliosis patients to lead a fulfilling life unencumbered by limitations, enabling them to live life to its fullest.

Why Choose MedPark Orthopedics Center?

• Quick access: Timely consultation with experienced spine specialists.
• Expedited Diagnosis: Rapid and efficient diagnostic procedures.
• Collaborative Multidisciplinary Approach: 24/7 systematic collaboration among diverse medical teams.
• Holistic Post-Treatment Care: Comprehensive care and management plans following treatment.
• Minimally Invasive Spine Surgery (MIS): Utilization of advanced minimally invasive surgical methods.
• Complete Array of Diagnostic Technology: Access to MRI, CT, and X-ray diagnostic technologies.
• Dedicated Team of Professionals: A team of committed nurses and physiotherapists for children and adults alike.
• Personalized Medical Devices: Tailoring of specialized medical devices to suit individual needs.

Individualized treatment planning

At MedPark Hospital, we provide individualized care by crafting personalized treatment plans for spinal conditions such as scoliosis and herniated discs. Our approach encompasses non-surgical and surgical options, adhering to the highest standards. This approach ensures pediatric and adolescent idiopathic scoliosis treatment, as well as adult idiopathic scoliosis treatment, provides the most effective and optimal outcomes.

Treatment and Management of Spinal Conditions and Scoliosis:

MedPark Hospital's skilled orthopedic surgeons are experts in addressing diverse spinal conditions, including various forms of scoliosis. We excel in treating and managing the following diseases and associated symptoms:

• Congenital Scoliosis
• Early Onset Scoliosis
• Idiopathic Scoliosis
• Neuromuscular / Syndromic Spinal Deformity
• Degenerative scoliosis
• Spondylolisthesis
• Kyphosis

Bracing: a non-surgical scoliosis treatment alternative

For children with scoliosis in their growth phase when the spine is still developing, the orthopedist may suggest the child wear a brace. This approach aims to mitigate the progression of scoliosis symptoms, straighten the spine for improved alignment, and permit unimpeded physical growth; this method enables children to engage in myriad activities without constraint.

Dedicated Rehabilitation Team:

MedPark has a proficient team of rehabilitation medicine physicians and physiotherapists. With extensive expertise in rehabilitation, they provide systematic and tailored care to patients, both pre- and post-treatment. Their objective is to expedite physical recovery by facilitating appropriate and personalized rehabilitation. This approach ensures continual growth and development through age-appropriate activities and empowers individuals to lead a life brimming with potential.