What is Scoliosis Surgery?
Our spine is an engineering marvel that supports our weight and ties our body along. The spinal column consists of a stack of little bones that aim size from 2-3 inches to 5-6 inches in diameter. once viewed from the front, the spine seems to be straight, however once checked out from the facet, the normal spine has two mild S-curves.
Scoliosis is an abnormal curvature of the spine. In scoliosis, the spine curves to the side once viewed from the front, and every vertebra conjointly twists on subsequent one in a very corkscrew fashion.
Scoliosis surgery is one in every of the longest and most complicated orthopedic surgical procedures performed on youngsters or adult. The operation takes close to six hours. Hospitalization will last many days and activities are restricted for many months. scoliosis is best treated once found early and might be detected throughout a routine school screening.
Scoliosis surgery is meant to reduce the patient’s curvature and fuse the spine to prevent any more progression of the deformity. Surgery for adolescents with scoliosis is barely recommended once their curves are larger than forty to forty five degrees and continued to progress, and for many patients with curves that are larger than fifty degrees. Severe curvatures (greater than fifty degrees) are additional probably to progress in adulthood. If a curve is allowed to make seventy – ninety degrees, it’ll not only end in a really disfiguring deformity, however can begin to end in cardiopulmonary compromise. each other, forming a C or S form within the spine.
What are Types of Scoliosis?
There are several types of scoliosis. Each of them are named and defined according to the age, cause of scoliosis and spinal curvature. There are two basic types of scoliosis:
1. Structural: is caused by neuromuscular diseases, certain infections, birth defects, injury, connective tissue disorders, metabolic diseases, rheumatic diseases, tumors and other unknown factors
2. Nonstructural: or functional scoliosis is reasoned by underlying conditions such as a difference in leg length, muscle spasms, or inflammatory conditions including appendicitis.
3. Idiopathic scoliosis: is the most common type of scoliosis based on age. It affects about 4% of the population, commonly females. The reasons may include differences in leg length, hereditary conditions, injury, infections and tumors. It is subdivided into three categories:
1. Infantile scoliosis: extends from birth to age three
2. Juvenile scoliosis: is caused between the ages three and nine
3. Adolescent scoliosis: scoliosis extends from 10 to 18
The Common Procedures for Scoliosis Surgery in India
1.Posterior Approach (Back): The posterior approach has been the gold standard for years to treat scoliosis and continues to be a surgical procedure applicable to most patients. The procedure usually involves implanting two metal rods (stainless steel or titanium) to correct the abnormal curvature. Sometimes more than two rods are needed. A combination of screws, hooks and wire may be used to anchor the rods to the spine. A spinal fusion procedure helps to weld the bone grafts and vertebral of the spinal column into a solid mass. Thoracoplasty involves rib resection (partial or total removal) to decrease the size of the rib hump caused by scoliosis. The rib bone can be used as a source of bone graft used in the fusion procedure. Today, with pedicle screw fixation, Thoracoplasty is less commonly performed than previously. The average hospital stay for most operations ranges from four to seven days.
2.Spinal fusion with instrumentation: Spinal fusion is the most widely performed surgery for scoliosis. In this procedure, bone (either harvested from elsewhere in the body autograft or from a donor allograft) is grafted to the vertebrae so that when it heals they will form one solid bone mass and the vertebral column becomes rigid. This prevents worsening of the curve, at the expense of some spinal movement. This can be performed from the anterior (front) aspect of the spine by entering the thoracic or abdominal cavity or, more commonly, performed from the back (posterior). A combination is used in more severe cases. Originally, spinal fusions were done without metal implants. A cast was applied after the surgery, usually under traction to pull the curve as straight as possible and then hold it there while fusion took place. Unfortunately, there was a relatively high risk of pseudarthrosis (fusion failure) at one or more levels and significant correction could not always be achieved.
3 Thoracoplasty: A complementary surgical procedure a surgeon may recommend is called Thoracoplasty (also called costoplasty). This is a procedure to reduce the rib hump that affects most scoliosis patients with a thoracic curve. A rib hump is evidence that there is some rotational deformity to the spine. Thoracoplasty may also be performed to obtain bone grafts from the ribs instead of the pelvis, regardless of whether a rib hump is present. Thoracoplasty can be performed as part of a spinal fusion or as a separate surgery, entirely. Thoracoplasty is the removal (or resection) of typically four to six segments of adjacent ribs that protrude. Each segment is one to two inches long. The surgeon decides which ribs to resects based on either their prominence or by determining those which are unlikely to be realigned by correction of the curvature alone. The ribs grow back, and will grow back straight.
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