Scoliosis Surgery

For people with scoliosis, a sideways curvature of the spine, casts and braces can sometimes keep the condition from getting worse. But if these treatments do not work, scoliosis surgery may be recommended.

Baptist Health is nationally recognized for excellence in scoliosis and spine surgery procedures. We offer a full spectrum of orthopedic and neurosurgical care specialists and the latest approaches to spine surgery. Best of all, you’ll appreciate convenient appointment times, locations near you and a personalized focus to meet your needs before, during and after your procedure.

What is Scoliosis Surgery?

The main goal of scoliosis surgery is to reduce the curvature of the spine, and any symptoms the curvature may cause. Scoliosis surgery may also:

• Reduce back pain
• Improve appearance and posture
• Reduce symptoms associated with severe scoliosis such as difficulty breathing, muscle weakness or numbness

The two main procedures are spinal fusion and vertebral body tethering.

Spinal Fusion

The most common surgical procedure to treat scoliosis is spinal fusion. In this procedure, two or more vertebrae are fused together so they cannot move independently of one another. Pieces of bone from your own body, bone from a donor, or a synthetic bone material are placed between the curved vertebrae, and held in place with rods, screws and wires. In younger patients who are still growing, an adjustable rod is used, and requires minimally invasive follow-up surgeries to lengthen the rods approximately every six months.

What Can I Expect During the Spinal Fusion Procedure?

Spinal fusion surgery is a major surgery that typically lasts four to eight hours depending on the size and location of the spinal curvature, and number of vertebrae being fused. The surgery is done under general anesthesia, and you will need to fast for at least 12 hours prior to surgery.

In some cases, your surgeon may be able to perform this procedure through a minimally invasive procedure instead of traditional open surgery. This approach uses specialized instruments inserted through multiple smaller incisions to reduce the surgery’s impact on nearby tissue and promote a faster recovery time.

Scoliosis Surgery Potential Risks

 Lumbar fusion is generally a safe procedure, but like all surgeries, it does have possible risks. These include:

• Infection
• Poor wound healing
• Bleeding
• Blood clots
• Blood vessel or nerve injury near the surgery site

Your doctor will provide instructions to help you prevent infection and damage to the wound.

It is important to understand that lumbar fusion will permanently affect how your spine functions. Because the fused vertebrae will no longer shift when you bend or straighten your back, other areas of the spine may experience greater stress. Your doctor and physical therapist can provide guidance to help you minimize stress on the spine and promote long-term healing.

Spinal Fusion Recovery

The recovery period for scoliosis surgery can vary greatly. Typically, you will stay in the hospital for three days or longer after your surgery, and receive oral or intravenous pain medications to help you manage the pain around the incision.

The first few days after scoliosis surgery are generally quite uncomfortable, but most patients are walking around by the third or fourth day, and ready to go home. You will likely need to stay home from work or school for three or four weeks, and may be given a back brace to help you feel more comfortable as you recover. The pain will gradually decrease until you no longer need pain medication, which generally takes four to six weeks. You should be almost completely recovered within about three months, but may continue to experience slight improvement for a year or more.

Your physician may determine that a program of physical therapy will benefit you after surgery. The type and extent of physical therapy depends on the specific procedure you had as well as your age, health and lifestyle. Your doctor may begin your rehabilitation program as early as a month after your procedure. In most cases, the rods and other hardware implanted in your back will not need to be removed unless they become infected or break. The fused portion of your back will remain permanently stiff, though you should still be able to perform daily activities and participate in most sports. You should be almost completely recovered within about three months, but may continue to experience slight improvements for a year or more.

Vertebral Body Tethering

A relatively new, minimally invasive procedure used to correct scoliosis in adolescents is vertebral body tethering, which involves connecting the curved vertebrae using screws and flexible tethers that can be tightened. This approach uses a compression technique that takes advantage of the adolescent’s natural growth to reduce the curvature of the spine.

VBT comes with advantages and potential risk factors. One of the greatest advantages for VBT is that it is less invasive than other surgeries, which usually means fewer risks will be involved. It also means that any potential additional surgeries would still be viable. VBT also allows the spine to continue growing, which typically helps the curve to correct. Additionally, because the procedure does not keep the spine from moving and bending, range of motion and movement tend to be better after VBT. Hospital stays also tend to be shorter with this surgery, which is convenient for both the patient and their families.

As with any spinal surgery, VBT does come with potential risk factors and complications. Although infection, nerve damage, or paralysis can happen in spinal surgery, it is rare with VBT. In some cases, an overcorrection in the thoracic spine and postural collapse (destabilization of the lumbar spine) have been reported. In rare instances, the tether may break, which can lead to destabilization of the spine.

There are several corrective measures that may be taken for these complications. The measures consist of an additional procedure to adjust the tension of the tether, a rehabilitation program to help restabilize the lumbar spine, or making “surgical cuts” in the discs or ligaments to achieve appropriate curve flexibility in the spine.

What Can I Expect During the Spinal Fusion Procedure?

Spinal fusion surgery is a major surgery that typically lasts four to eight hours depending on the size and location of the spinal curvature, and number of vertebrae being fused. The surgery is done under general anesthesia, and you will need to fast for at least 12 hours prior to surgery.

In some cases, your surgeon may be able to perform this procedure through a minimally invasive procedure instead of traditional open surgery. This approach uses specialized instruments inserted through multiple smaller incisions to reduce the surgery’s impact on nearby tissue and promote a faster recovery time.

Scoliosis Surgery Potential Risks

 Lumbar fusion is generally a safe procedure, but like all surgeries, it does have possible risks. These include:

• Infection
• Poor wound healing
• Bleeding
• Blood clots
• Blood vessel or nerve injury near the surgery site

Your doctor will provide instructions to help you prevent infection and damage to the wound.

It is important to understand that lumbar fusion will permanently affect how your spine functions. Because the fused vertebrae will no longer shift when you bend or straighten your back, other areas of the spine may experience greater stress. Your doctor and physical therapist can provide guidance to help you minimize stress on the spine and promote long-term healing.

Spinal Fusion Recovery

The recovery period for scoliosis surgery can vary greatly. Typically, you will stay in the hospital for three days or longer after your surgery, and receive oral or intravenous pain medications to help you manage the pain around the incision.

The first few days after scoliosis surgery are generally quite uncomfortable, but most patients are walking around by the third or fourth day, and ready to go home. You will likely need to stay home from work or school for three or four weeks, and may be given a back brace to help you feel more comfortable as you recover. The pain will gradually decrease until you no longer need pain medication, which generally takes four to six weeks. You should be almost completely recovered within about three months, but may continue to experience slight improvement for a year or more.

Your physician may determine that a program of physical therapy will benefit you after surgery. The type and extent of physical therapy depends on the specific procedure you had as well as your age, health and lifestyle. Your doctor may begin your rehabilitation program as early as a month after your procedure. In most cases, the rods and other hardware implanted in your back will not need to be removed unless they become infected or break. The fused portion of your back will remain permanently stiff, though you should still be able to perform daily activities and participate in most sports. You should be almost completely recovered within about three months, but may continue to experience slight improvements for a year or more.

Vertebral Body Tethering

A relatively new, minimally invasive procedure used to correct scoliosis in adolescents is vertebral body tethering, which involves connecting the curved vertebrae using screws and flexible tethers that can be tightened. This approach uses a compression technique that takes advantage of the adolescent’s natural growth to reduce the curvature of the spine.

VBT comes with advantages and potential risk factors. One of the greatest advantages for VBT is that it is less invasive than other surgeries, which usually means fewer risks will be involved. It also means that any potential additional surgeries would still be viable. VBT also allows the spine to continue growing, which typically helps the curve to correct. Additionally, because the procedure does not keep the spine from moving and bending, range of motion and movement tend to be better after VBT. Hospital stays also tend to be shorter with this surgery, which is convenient for both the patient and their families.

As with any spinal surgery, VBT does come with potential risk factors and complications. Although infection, nerve damage, or paralysis can happen in spinal surgery, it is rare with VBT. In some cases, an overcorrection in the thoracic spine and postural collapse (destabilization of the lumbar spine) have been reported. In rare instances, the tether may break, which can lead to destabilization of the spine.

There are several corrective measures that may be taken for these complications. The measures consist of an additional procedure to adjust the tension of the tether, a rehabilitation program to help restabilize the lumbar spine, or making “surgical cuts” in the discs or ligaments to achieve appropriate curve flexibility in the spine.