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Practice Policy Update Regarding COVID-19

Surgery for Scoliosis

Jeremy S. Smith, M.D., Orthopaedic Spine Surgeon, Orange CA / Patient Info / Spine / Spine Procedures / General / Surgery for Scoliosis
Surgery for Scoliosis

Surgery for scoliosis is recommended when the spinal curvature is severe and is either worsening or is a cause of severe pain or difficulty in breathing. The surgery is aimed at rectifying the spinal curvature, stabilizing the spine and preventing it from worsening. The rectification of the curved spine involves removal of one or more intervertebral discs (discectomy), vertebrae or spinous processes from the curved segment of the spine. The gaps in the bones are then filled with a bone graft. Ribs can be a source for the bone graft. Rods and screws are used to permanently fix the spine in the rectified position.

Scoliosis surgery is major surgery. It is performed under general anesthesia and may require several hours to complete. An open approach or minimally invasive approach can be used for the surgery. The surgery can be performed either from the back (posterior approach) or the front of the body (through the abdomen or chest wall). Sometimes a more complex anterior-posterior approach is required. This is a very demanding surgery for the surgeon as well as the patient. Two surgeries are done, one from the front and the other from the back, with a gap of a few days between them.

The surgical approach and type of surgery depend on various factors which include the age of the patient, cause of scoliosis, location, and degree of the curve and its progressive nature. Apart from this, other associated symptoms and the presence of co-existing conditions such as diabetes, endocrine dysfunction, and bone diseases, are also taken into consideration. The risk of the surgery may include infection, bleeding, nerve damage and reaction to general anesthesia.

Pre-operative Care

Before the surgery, each case is assessed individually based on the results of the various diagnostic tests such as blood tests, X-rays and other imaging tests as well as the presence of any co-existing conditions such as cardiopulmonary disease and diabetes. Based on this evaluation, the surgeon then recommends the most appropriate surgical approach for each patient. The surgeon will also discuss the benefits and potential risks and complications of the recommended approach with the patient.

The surgeon may also pre-plan the surgery using the latest image-guided technology to create a three dimensional model of the patient’s spine to guide the surgeon during the surgery. Image-guided surgery helps in more precise and accurate placement of the implants and ensures a better and safer outcome of the surgery.

Post-operative Care

After the surgery, the nurses and the medical staff ensure appropriate management of your post-operative care. Pain medications will be administered to keep you comfortable and your vital signs are closely monitored. In most cases, the hospital stay is around a week but may differ depending on each individual case and the nature of surgery performed.

Post-operative instructions

  • Take prescribed medications regularly.
  • Always keep the incision clean and dry. You may shower but will need to cover the incisions to ensure they do not get wet.
  • Tub baths and swimming are strictly forbidden until the incisions heal.
  • Follow physical therapy as advised.
  • Avoid lifting or carrying objects heavier than a shoe.
  • Follow a healthy lifestyle to improve healing such as quitting smoking, eating a healthy nutritious diet, taking rest frequently and regular walking.
  • Do not drive unless allowed by the surgeon. You can travel in the car, but only for short distances.

What are the Associated Risks?

  • Fever higher than or equal to 101°F
  • Increase in swelling and redness around the incision
  • A noticeable change in the odor, color or quantity of the incision drainage
  • Numbness in the genital area
  • Loss of bowel and bladder function: Contact the surgeon immediately as it is a medical emergency

Consult your surgeon for any doubts or queries about scoliosis surgery and the associated benefits and risks.

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