Scoliosis Surgery
Scoliosis is a sideways twisting curvature of the spine, or backbone. The bones that make up the spine are called vertebrae. Some people who have scoliosis require treatment. Other people, who have milder curves, may only need to visit their doctor for periodic observation.
Can People with Scoliosis Exercise?
Exercise does not make scoliosis worse. In fact, it is very important for all people, including those with scoliosis, to exercise and remain physically fit.
In 80 to 85 percent of people, the cause of scoliosis is unknown. Before treating scoliosis, the doctor looks for other possible causes, such as injury or infection. Causes of curves are classified as either nonstructural or structural.
A structurally normal spine that appears curved. This is a temporary, changing curve. It is caused by an underlying condition such as a difference in leg length, muscle spasms, or inflammatory conditions such as appendicitis. Doctors treat this type of scoliosis by correcting the underlying problem.
A fixed curve that doctors treat case by case. Most of the time the cause is unknown. Sometimes structural scoliosis is one part of a syndrome or disease, such as Marfan's syndrome, an inherited connective tissue disorder. Structural scoliosis can be caused by neuromuscular diseases such as cerebral palsy, poliomyelitis, or muscular dystrophy; birth defects such as hemivertebra, in which one side of a vertebra fails to form normally before birth; injury; certain infections; tumors such as those caused by Neurofibromatosis, a birth defect sometimes associated with benign tumors on the spinal column; metabolic diseases; connective tissue disorders; rheumatic diseases or unknown factors.
Many surgical techniques can be used to correct the curves of scoliosis. The main surgical procedure is correction, stabilization and fusion of the curve. Fusion is the joining of two or more vertebrae. Surgeons can choose different ways to straighten the spine and also different implants to keep the spine stable after surgery. Implants are devices that remain in the patient after surgery to keep the spine aligned. The decision about the type of implant will depend on the cost; the size of the implant, which depends on the size of the patient; the shape of the implant; its safety and the experience of the surgeon.
Scoliosis changes the spine in two directions. The spine curves unnaturally from a side view and also from the front or back. The curve is usually S-shaped or C-shaped. Doctors measure the amount of curvature in degrees. Under thirty degrees is considered mild, and over sixty degrees is considered severe. After adolescence passes, mild curvature often stays mild, but severe curvature often gets worse.
Treatments such as chiropractic have not been shown to be successful in reversing the progress of the curvature, although they can reduce pain.
When making a decision about treatment of scoliosis, doctors look at the age of the person. For a young person with mild curvature who seems to be getting worse, a brace may be prescribed to prevent deformity.
As a young person gets worse, the spine curves, the chest twists, and both the shoulder blade and the hips move to an unnatural position. A brace worn 16 hours or more each day has been shown to prevent curves from becoming worse. These braces, however, tend to be uncomfortable and hard to live with. Teenagers, especially, find them ugly, even though the braces cannot be detected under most kinds of clothes.
Surgery can reduce the curve as well as the deformity and the pain it can cause. In most cases, doctors recommend surgery for young people with a curve of forty to fifty degrees. It involves placing metal rods or screws to help straighten and hold the spine in the corrected position.
Surgeons base their procedures on many different factors including their experience with techniques and their outcomes.
