When faced with the prospect of scoliosis surgery, it’s normal to have many questions. In this article we share our answers to the questions we are most frequently asked.
Scoliosis is a three-dimensional deformity of the spine. It involves deviation in three primary planes: a curvature of more than 10º in the frontal plane, in addition to deviation in the sagittal and transverse planes.
This pathology has various causes (traumatic injury, neurological diseases, etc.), although in most cases, the cause is unknown. In these cases, it is called idiopathic scoliosis. Scoliosis is also classified according to the age of the patient, as infantile, adolescent or adult scoliosis, each having very different characteristics.
In some cases, this pathology can be addressed with a conservative treatment option, such as wearing an orthopedic brace, or with pain medication, but in certain cases, the most effective treatment option is surgery to correct the scoliosis. In the following paragraphs we answer some of the questions we are most frequently asked about this kind of spine surgery.
In which cases is surgery recommended for scoliosis?
Whether or not surgery is recommended, always depends on the specific patient and their specific condition.
In the case of scoliosis in children and adolescents, treatment by using an orthopedic brace is usually enough. However, if the curvature of the spine is very pronounced (more than 45-50 degrees), the recommended option is surgical treatment.
For adults with scoliosis, using an orthopedic brace is not an effective treatment option. The main goal in treating adult scoliosis is to relieve back pain, so the first step is to use pain medication or epidural infiltrations. These steps are useful to relieve pain, but cannot prevent the condition from worsening. For this reason, depending on the specific patient’s case, surgical treatment may be recommended.
Because surgery to correct scoliosis is highly complex, it is very important to take into account the patient’s age and whether they have any other pathologies, among other factors, in order to decide whether surgery is the best treatment option.
Is it an invasive type of surgery?
Yes, scoliosis surgery is an invasive surgery that requires a posterior opening in the back in order to correct the entire spine. However, it is possible to combine different approaches when performing spinal fusion surgery, or arthrodesis, one of which is the anterior approach, which is less invasive.
What kind of technology is used in this surgery?
One of the most important aspects of this surgery is planning, which allows the surgeon to anticipate the results of the surgery. At Instituto Clavel, we begin with using the EOSedge scanner get a full-body diagnostic image of the patient’s spine, so that we can see and analyze all the angles and shapes of the scoliosis. From this, we construct a 3D simulation of the result we will achieve with the operation.
This allows us to design the made-to-measure implant we are going to use, so that the surgery is customized precisely for the specific patient. We are currently the only center in Spain that makes custom rods for scoliosis surgery.
Apart from this, in the operating room we use intraoperative neurophysiological monitoring of the patient's nerve activity to ensure their safety throughout the operation. During this surgery, the surgeon works very close to the spinal cord, so the real-time monitoring is essential to reduce the risk of neurological damage.
Is scoliosis surgery permanent?
Yes, after the operation, the part of the spine that has been fused can no longer move, so the result is final.
However, it’s important to note that in most cases, only part of the spine is fused, so the rest of the spine will still be mobile, and in the long term, will undergo the natural process of wear and tear that comes with age. However, if the spine is well stabilized, this progression will be painless.
What is the postoperative experience like?
Because this is a complex surgery that involves manipulation of various structures in the spine, the patient remains for one or two nights in the intensive care unit (ICU). After this, the length of time the patient needs to stay in the hospital depends on their age. In the case of adolescents, they can be sent home after only a few days; adults should expect to stay in the hospital from 10 to 15 days. Of course, during this time in the hospital they will begin walking, and will be able to go home on foot.
Is it necessary to wear an orthopedic brace after surgery?
In the case of adolescents, this is not necessary, but adults will need to wear a brace for two or three months following their scoliosis surgery, to ensure better stability and safety.
When is it possible to return to work?
The right time to return to work will depend on each patient, their condition, and the type of work they do. Patients whose jobs do not require significant physical exertion will be able to return to work sooner than those whose jobs involve physical labor.
Rehabilitation at Instituto Clavel is totally personalized and focuses on patients being able to resume their normal daily activities as soon as possible.
We hope this article has answered most of your questions. However, if you have more, or if you need an evaluation of your personal case, please don’t hesitate to contact us.