The following talk is one aimed at surgeons interested in learning how to place thoracic pedicle screws for spinal deformity surgical treatment.
In 2022, spine deformity surgery usually requires a long incision and temporary retraction of muscles from the spine. This extensive exposure of the spine helps to loosen up the spine (to get better correction), insert pedicle screws to grip the spine and place the long rods, which moves the spine in space and maintains the […]
In the previous blog post, we presented “what is a spine fusion”? In most pediatric spine surgeries metal implants correct and stabilize the spine in a new position (see below), then a spine fusion is performed. What I tell families/patients: “The metal allows us to attain and maintain the spine in a new position while […]
1. Preoperatively At At the last outpatient clinic visit before surgery, all patients will also have a visit with the Pediatric Anesthesia service on the same day. This group of physicians and Advanced Practice Providers (AAPs) will provide the general anesthesia (means the patient will be asleep) for the entire surgical procedure AND […]
In the last blog post I presented the position that 100% correction of the three-dimensional spinal deformity is NOT needed for optimal painless, long-term function. However, to create the ideal aesthetic or cosmetic appearance of the body, from shoulders to the hips, achieving >90% correction is probably what is needed to completely normalize the body […]
6 months ago in the April 5th, 2021 blog post I addressed the question I sometimes get asked after surgery by parents, families and caregivers: “How much correction of the scoliosis did you get during surgery?” This blog post I will try to explain why we don’t always want 100%, or even 90% or 80% […]
This is a common question asked after spinal deformity surgery. Parents and caregivers are interested in how close their child’s spine was able to be returned to a “normal” alignment on x-ray. It is a very reasonable question. I would probably ask a similar question if my child was having scoliosis surgery. As a parent, […]
Sometimes our precious patients listen to us and other times…………………………………………not so much.
Back in July (7-28-2020) I published two blog post on spine wounds, specifically the concepts and methods used to close the incisions used during spine surgery, mainly posterior spinal fusion incisions in pediatric and adolescent patients. As I explained previously the goal in the end is a nice narrow (or thin) scar which blends into […]
The long-term appearance of a planned surgical scar is a common concern before surgery. Sometimes this question is asked to us, other times it is not, likely because people do not want to appear overly concerned or vain about appearance or aesthetics of their skin. Either way, the concern exists and is valid. Why would […]
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 […]
When can I return to driving after surgery? The ability to return to driving after orthopedic spine surgery us dependent on several factors including the type of surgery performed, the type of car (manual vs automatic) and the surgical site. Studies using driving simulators have been able to estimate when braking function and reaction […]
A big factor in the outcome of a healthcare treatment, such as surgery, is the concept of Engagement. Engagement means to interact with something and, in the context of healthcare, means the physician, nursing, support staff and hospital. It is an active process and implies two-way communication. It is not just the physician or nurse […]
In the blog post from December 17th, 2018 the operative risks which are common to all surgical procedures done under general anesthesia were presented. This post will focus on the one of the risks unique to spinal deformity surgery: New neurologic deficits. This includes paralysis, leg/arm weakness, sensory changes, bowel and bladder incontinence, etc…these are […]
In order to minimize the risks of spinal deformity surgery for scoliosis, kyphosis, spondylolisthesis, spondylolysis, etc….. Obtaining a thorough medical history is necessary, along with a physical examination, blood work and imaging studies. Shared decision-making is important during discussion about surgery, along with the alternatives to surgery, the benefits of surgery, potential complications and risks. […]