Our Summary

This research paper discusses the various surgical techniques and implants used to treat scoliosis in children and teenagers. Scoliosis is a condition where the spine curves to the side, and in severe cases, surgery is required to correct it. The goal of these surgeries is to stop the spine from curving further and straighten it as much as possible. The authors look at several types of surgical implants, such as Harrington rods, Luque rods, Luque-Galveston implants, and segmental spinal fusion systems.

However, these methods don’t work as well for children with early onset scoliosis, as they’d interfere with lung growth. Therefore, other devices have been created to correct the curve while allowing the spine to grow. These include growing rods attached to the spine, titanium rods that can be expanded (though this requires multiple surgeries), and rods controlled by magnets.

The authors also discuss more recent systems like Shilla and thoracoscopic anterior vertebral body tethering, which allow the spine to grow without needing multiple surgeries. The paper also reviews how these different implants and techniques look on medical images, and the common complications that can occur after surgery.

FAQs

  1. What are some of the surgical techniques and implants used to treat scoliosis in children and teenagers?
  2. Why don’t traditional surgical methods work as well for children with early onset scoliosis and what alternatives are available?
  3. What are some common complications that can occur after scoliosis surgery?

Doctor’s Tip

One helpful tip a doctor might give a patient about scoliosis surgery is to follow the post-operative care instructions carefully to ensure proper healing and to prevent complications. This may include restrictions on physical activity, wearing a brace as directed, attending physical therapy sessions, and following up with the surgeon for regular check-ups. It is also important for the patient to communicate any concerns or changes in symptoms to their healthcare provider promptly.

Suitable For

Typically, patients who are recommended for scoliosis surgery are those who have a severe curvature of the spine that is causing pain, difficulty breathing, or impacting their quality of life. These patients may have tried other non-surgical treatments such as bracing or physical therapy without success. Additionally, surgery may be recommended for patients who have a progressive curve that is getting worse over time, or for those who have a curve that is affecting their internal organs.

It is important for patients and their families to discuss the risks and benefits of surgery with their healthcare provider, and to consider factors such as age, overall health, and the severity of the curve when making a decision about whether to proceed with surgery. Ultimately, the decision to undergo scoliosis surgery should be made on a case-by-case basis after a thorough evaluation by a medical professional.

Timeline

Before scoliosis surgery:

  1. Diagnosis of scoliosis through physical examination and imaging tests.
  2. Monitoring of the curve progression through regular check-ups.
  3. Evaluation of non-surgical treatment options such as bracing or physical therapy.
  4. Discussion with the surgeon about the surgical procedure, risks, and potential outcomes.
  5. Pre-surgical preparation including medical tests, physical therapy, and education about post-operative care.

After scoliosis surgery:

  1. Recovery in the hospital for a few days to a week, depending on the type of surgery.
  2. Pain management and physical therapy to regain strength and mobility.
  3. Gradual return to normal activities and school, with restrictions on certain movements.
  4. Regular follow-up appointments with the surgeon to monitor the healing process and spine alignment.
  5. Long-term monitoring of the spine to ensure that the curve does not worsen after surgery.
  6. Continued physical therapy to maintain spinal health and prevent complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. What type of surgical technique do you recommend for my specific case of scoliosis?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery process, and what can I expect during the recovery period?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. What is the long-term outlook for my spine after this surgery?
  6. Will I need additional surgeries or treatments in the future?
  7. Are there any alternative treatments or approaches to surgery that I should consider?
  8. How experienced are you in performing this type of surgery?
  9. What is the success rate for this type of surgery in patients with similar conditions?
  10. Are there any lifestyle changes or restrictions I should be aware of after the surgery?

Reference

Authors: Alsharief AN, El-Hawary R, Schmit P. Journal: Pediatr Radiol. 2018 Jan;48(1):124-140. doi: 10.1007/s00247-017-3941-7. Epub 2017 Sep 8. PMID: 28887681