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Scoliosis is an abnormal sideways (lateral) curvature of the spine. Scoliosis is managed according to the presenting factors.
Scoliosis is an abnormal sideways (lateral) curvature of the spine. The spinal column (backbone) of the patient with this condition curves and twists, so rotating the ribcage. X-rays of individuals with scoliosis show an ‘S’ or a ‘C’ shaped curve rather than a straight line. Scoliosis can be disfiguring and often presents with a hump. Scoliosis affects approximately 2% of the population to some degree but serious noticeable curves are much less common. (see Fig. 1).
Scoliosis is managed according to the presenting factors. For small curves, we start with exercise and regular monitoring. If during monitoring, an increasing curve occurs before or during puberty, then the consultant may advise a spinal brace. Even with regular exercise, monitoring and regular use of braces, some patients whose curves keep progressing may be referred for surgery.
Surgical treatment usually combines correction and straightening of the curvature and deformity with implanted rods and fusion of the involved vertebrae. This means that the levels fused act as one column of bone. Operations for scoliosis can be carried out from the front (anterior) or the back (posterior).
Patients with more severe curvatures might need both an anterior and posterior approach performed. In the hands of a skilled surgeon, neither approach is clearly superior. The consultant will advise you which surgical approach would be most appropriate. Scarring is kept to the minimal for most patients. Invisible sutures are used internally that dissolve and sterri strip plasters are used for the skin.
Surgery in an adult carries a higher rate of complications and risks than in a child or teenager. Immediate risks of surgery include:
This depends largely on how many vertebrae are fused, and where in the back these vertebrae are located. Fusing just the middle of the back (the thoracic vertebrae) will not significantly impact the forward bending flexibility, since these vertebrae connect to the ribcage which is fairly rigid anyway.
Fusing the upper back and neck (the cervical region) will limit the bending and twisting flexibility in your neck somewhat, but usually not severely.
The five lumbar vertebrae at the base of the spine are the most important for bending; flexibility and when these are affected by the surgery noticeable stiffness will result. The aim of the surgery is to stabilise the spine by fixing as few vertebrae as possible.