University Spine Center specializes in pediatric scoliosis spine surgery. We understand it is overwhelming for you and your child to face spine surgery. Our orthopaedic spine surgeons are parents too, and take the time necessary to compassionately explain why and how surgery can improve your child’s scoliosis and stop it from getting worse. This article is a summary of key information to help answer your immediate questions.
The goal of surgery is to prevent further curve progression and improve deformity.
Pediatric orthopaedic spine surgeons usually recommend surgical treatment (1) if the curve is larger than 45 degrees, (2) the curve is progressing, and (3) the child is still growing.
What does surgery involve?
Scoliosis surgery involves general anesthesia, spinal instrumentation and fusion.
- General anesthesia is administered by an anesthesiologist, who monitors your child’s sleep state (unconsciousness), breathing and other vital functions.
- Instrumentation refers to devices such as contoured rods and screws that are implanted and immediately stabilize the spine (hold it in position). Certain types of instrumentation enable the surgeon to re-align the spine into a more normal shape.
- Fusion uses bone graft to stimulate bone to heal. There are different types of bone graft, such as the patient’s own bone (autograft) and donor bone (allograft). Bone graft is packed between and around the instrumentation. Soon, new bone begins to grow around the instrumentation, the bone heals and over time fuses (joins together) the spine.
How does the surgeon access the spine?
Your surgeon may approach the spine from the front of the body (anterior), back (posterior), or a combination of anterior and posterior.
The size of the incision depends on many factors such as the size of the curve(s). Open surgery means a longer incision, which may be necessary to expose several levels of the spine.
One type of minimally invasive spine surgery is thoracoplasty. It is not appropriate for all pediatric scoliosis patients. Thoracoplasty involves making small incisions (called portals) in the patient’s chest wall. An endoscope, a narrow flexible tube with light and a camera enables the surgeon to view the surgery on a large video screen in the operating room. Surgery is performed through the portals.
How does the surgeon re-align my child’s spine?
Well in advance of your child’s spine surgery, your surgeon pre-plans the surgery. University Spine Center’s orthopaedic surgeons utilize the latest tools and imaging technology to pre-calculate each step of the procedure.
Surgical pre-planning enables your child’s surgeon to know if disc and/or bone material needs to be removed so the curve can be better reduced and re-aligned. Discectomy involves removing one or more intervertebral discs (soft pads between the vertebral bodies). Osteotomy involves removing bone.
Thereafter, instrumentation is implanted and immediately stabilizes the spine. Bone graft is added to stimulate bony ingrowth that fuses the spine together (fusion). Intra-operative imaging (e.g., x-rays) confirms each step of the process. The incision(s) are closed and dressed with a bandage.
What happens after surgery?
Your child is moved into the recovery area where medical specialists monitor all vital signs—breathing, pulse, blood pressure, body temperature, and post-operative pain. Pain medication is administered to manage your child’s pain.
Next steps …
Well in advance of surgery, we provide information about length of hospitalization, discharge instructions, pain medication (if necessary), and home-care tips.
We are available to answer all your questions
We encourage you to write down your questions and bring them with you to be answered during your child’s next appointments.
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