Friday, May 29, 2020

Scoliosis Surgery Frequently-Asked Questions

1. How do I know if I have scoliosis?
            Uneven shoulders or hips, or asymmetry of the contour of the back (which is more obvious with forward bending) can be visual tip-offs that scoliosis is present.  Also, individuals with a family history of scoliosis are more likely to have scoliosis.  Assessment by primary care physicians can typically identify an individual with these types of body asymmetry and, if any is detected, a single radiograph (x-ray) from the front/back of the thoracic and lumbar spine (from collar bones to hips) is indicated to definitively diagnose scoliosis.

2. Is there someone I can talk to who has scoliosis?
            Yes, we can connect you with other individuals (patients, parents, caregivers) who would be willing to discuss the issues and problems of scoliosis on a first-hand basis.

3. Is scoliosis caused by not drinking enough milk or eating too much junk food?
            No, though both of these may impact the long-term health of the spine by decreasing the overall bone mass of the body.  Low spinal bone mass as an adolescent can become magnified in one’s 60’s, 70’s and 80’s and can increase the risk of osteoporotic spinal fractures.

4. Does scoliosis hurt?
            Mild scoliosis does not cause pain.  Moderate to severe scoliosis can increase the likelihood of activity-related musculoskeletal pain.

5. Why do kids get scoliosis?
            The cause of “garden-variety” scoliosis is unknown.  Some researchers have found an association between scoliosis and a very subtle form of neurological abnormality which has no outward manifestations besides the scoliosis.  Current research is ongoing to identify the specific genes responsible for scoliosis.

6. What are the goals and expectations of scoliosis surgery?
            The classic type of scoliosis surgery is a spinal fusion.  In this surgery a segment of the spine is corrected to the optimal 3-d alignment and then fused to eliminate motion between the vertebral body segments.  At the time of surgery the malalignment of the spine is corrected as much as possible toward normal alignment.  The use of spinal implants (metal screws, hooks and rods) permits straightening of the spine and also maintains the correction as the spine fusion heals after surgery.  Newer techniques for correction of scoliosis which do not “fuse” the spine are in the development (vertebral body tether and Apifix) and early adoption phase and hopefully will decrease the need for spinal fusions.

7. How much correction do you expect to achieve at the time of spine fusion?
            The amount of correction depends on multiple patient factors: patient age, curve size, location and flexibility, presence of other curves, concomitant medical problems, previous surgery, etc....  Judicious correction of the scoliosis is always indicated as overcorrection of the spine can lead to temporary or permanent neurological injury, such as nerve root deficits or paralysis.