Scoliosis surgery

"** Scoliosis Surgery may be used to treat severe scoliosis.

Surgery may be used to treat severe scoliosis. The goal of surgery is to improve a severe spinal curve. The result will not be a perfectly straight spine, but the goal is to balance the spine and to make sure the curve does not get worse.

Surgery usually involves stabilizing the spine and keeping the curve from getting worse by permanently joining the vertebrae together.

Posterior fusion with instrumentation has been a standard of the surgical treatment for scoliosis. In modern instrumentation systems, more anchors are used to connect the rod and the spine, resulting in better correction and less frequent implant failures.

Segmental pedicle screw constructs or hybrid constructs using pedicle screws, hooks, and wires are the trend of today.

Anterior instrumentation Scoliosis surgery had been a choice of treatment for the thoracolumbar and lumbar scoliosis because better correction can be obtained with shorter fusion levels. Recently, superiority of anterior surgery for the thoracolumbar and lumbar scoliosis has been lost. Initial enthusiasm for anterior instrumentation for the thoracic curve using video assisted thoracoscopic Scoliosis surgery technique has faded out.

Various attempts are being made with use of fusionless Scoliosis surgery. To control growth, epiphysiodesis on the convex side of the deformity with or without instrumentation is a technique to provide gradual progressive correction and to arrest the deterioration of the curves.

To avoid fusion for skeletally immature children with spinal cord injury or myelodysplasia, vertebral wedge ostetomies are performed for the treatment of progressive paralytic scoliosis. For right thoracic curve with idiopathic scoliosis, multiple vertebral wedge osteotomies without fusion are performed.

To provide correction and maintain it during the growing years while allowing spinal growth for early onset scoliosis, technique of instrumentation without fusion or with limited fusion using dual rod instrumentation has been developed.

To increase the volume of the thorax in thoracic insufficiency syndrome associated with fused ribs and congenital scoliosis, vertical expandable prosthetic titanium ribs has been developed.

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