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Implants that aim to delay spinal fusion and to allow more spinal growth in young children is the gold standard for surgical treatment of early onset scoliosis. Surgery without fusion can be divided into three principles: distraction of the entire spine, compression of the short segment of spine, and guided-growth techniques.
Following the procedure, it is common for a surgical operation such as spinal fusion surgery to be performed afterward to permanently mend the issue. [14] [17] It is utilized before the operation to reduce the need for a more dangerous surgery and to reduce the risk of damage to the soft tissues or nerves that surround the spine during the surgery.
Spinal fusion is usually needed when a curvature reaches 40 degrees. However, there is a window of opportunity for a minimally invasive surgery. The curvature needs to be between 0 and 70 degrees. Minimal rib rotation and only one curve is preferred. Also, minimally invasive spinal fusions are almost always only done in the thoracic region.
In the spine, there is bone formation along the anterior longitudinal ligament and sometimes the posterior longitudinal ligament, which may lead to partial or complete fusion of adjacent vertebrae. The facet and sacroiliac joints tend to be uninvolved. The thoracic spine is the most common level involved. [2]
Surgeons who are specialized in spine surgery perform surgery for scoliosis. To completely straighten a scoliotic spine is usually impossible, but for the most part, significant corrections are achieved. [105] The two main types of surgery are: [106] Anterior fusion: This surgical approach is through an incision at the side of the chest wall.
Spinal fusion is a high risk surgery and complications can be serious, including death. In general, there is a higher risk of complications in older people with elevated body mass index (BMI), other medical problems, poor nutrition and nerve symptoms (numbness, weakness, bowel/bladder issues) before surgery. [ 4 ]
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