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Kendall Regional Medical Center
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Pediatric ER
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Surgical Procedures for Scoliosis

Surgery is usually reserved for severe cases of scoliosis with a degree of curvature over 40°-50°.

The goals of surgery are to:

  • Stop the progression of scoliosis
  • Lessen the curve
  • Avoidance of complications in adulthood, such as lung disease due to restriction of a deformed chest cavity

Many types of techniques can be used for scoliosis. These techniques have some or all of the following in common:

  • Efforts to restore some symmetry to the torso and pelvic areas.
  • Supporting the vertebrae.
    • This can be done with or without hardware, such as steel rods, screws, or hooks.
    • Procedures can be done with or without spinal fusion .

The type of surgery done will depend on your child's age.

Fusion Surgery

Spinal fusion surgery involves joining together adjacent vertebrae to result in growth into one solid bone. This results in permanent restrictions on certain types of movement. The restriction depends on how many bones are fused together. Hardware is used to keep the spine in place while the bones fuse together. Fusion surgery is only considered in children who are older than 8 years of age. It is most likely to be done in adolescents who are close to full growth.

Cortel-Dubousset Procedure

This is one of the most common surgeries performed for scoliosis. This type of surgery is a posterior spinal fusion. A metal rod is attached to each side of the spine by using hooks attached to the vertebral bodies. The spine is then fused with a piece of bone from the hip area. The bone grows in between the vertebrae and holds them together and straight. The metal rods attached to the spine help the backbone remain straight while the spinal fusion takes place.

Thoracoscopic Anterior Instrumentation

Small incisions are made for insertion of a thoracoscope and surgical instruments. Thoracoscopic surgery is less invasive, but in some studies surgery and recovery times appear to be longer than conventional surgery. Although there are some benefits to this type of surgery, serious post-surgical complications are possible. If this surgical procedure is an option for your child, be sure to weigh out all the options with the doctor.

Non-Fusion Surgery

Non-fusion surgical procedures are designed to help the curve correct itself over time. These procedures do not restrict movement once the spine has healed. Some of these are somewhat new procedures, and may not be available everywhere.

  • Epiphysiodesis —This procedure is designed to stop growth on one side of the spine. The other side of the spine will continue to grow. There will be slow, progressive correction.
  • Vertebral body stapling —Staples are used through thoracoscope and insterted into the spine. The staple acts as a clamp to stabilize the spine. Depending on the severity of the curve, a rod may be used to stabilize the spine while it heals.
  • Vertebral wedge osteotomy —A wedge-shaped portion of the bone in the spine is cut out on one side of the curve. The open space left in the spine is then closed together. A temporary rod is inserted while the bones heal.
  • Magnetically controlled growing rods —A rod is implanted to straighten the spine. Growth adjustments to the rod are done with a magnet, minimizing invasive surgical procedures.

Revision Information

  • Adolescent idiopathic scoliosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116647/Adolescent-idiopathic-scoliosis. Updated March 18, 2017. Accessed May 16, 2017.

  • Altaf F, Gibson A, Dannawi Z, Noordeen H. Adolescent idiopathic scoliosis. BMJ. 2013;346:f2508.

  • Congenital scoliosis and kyphosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908760/Congenital-scoliosis-and-kyphosis. Updated January 19, 2016. Accessed May 16, 2017.

  • Idiopathic scoliosis in children and adolescents. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: http://orthoinfo.org/topic.cfm?topic=A00353. Updated March 2015. Accessed May 16, 2017.

  • Infantile and juvenile idiopathic scoliosis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T908759/Infantile-and-juvenile-idiopathic-scoliosis. Updated July 13, 2016. Accessed May 16, 2017.

  • Kim KT, Park KJ, Lee JH. Osteotomy of the spine to correct spinal deformity. Asian Spine J. 2009;3(2):113-123.

  • Maruyama T, Takeshita K. Surgical treatments of scoliosis: a review of techniques currently applied. Scoliosis. 2008;3:6.

  • Reddi V, Clarke DV Jr, Arlet V. Anterior thoracoscopic instrumentation in adolescent idiopathic scoliosis: a systematic review. 2008;33(18):1986-1994.

  • Questions and answers about scoliosis in children and adolescents. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/Health%5FInfo/Scoliosis/default.asp. Updated December 2015. Accessed May 16, 2017.

  • Trobisch P, Suess O, Schwab F. Idiopathic scoliosis. Dtsch Arztebl Int. 2010;107(49):875-883.

  • What is scoliosis? Fast facts: An easy-to-read series of publications for the public. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/Health%5FInfo/Scoliosis/scoliosis%5Fff.asp. Updated November 2014. Accessed May 16, 2017.