A person’s spine is supposed to
be straight to perform day to day activities, but what happens when it turns
curvy? May be of ‘S’ shape or ‘C’ shape? Does that only affect cosmetic
elegance or is there something the individual should worry about?
When the curve in the spine is almost 10
degrees, it is regarded as Scoliosis. Degenerative Scoliosis majorly caused by
spinal degeneration that leads to spinal column malalignment as in side to side
curve in the spine. Also known as adult-onset
scoliosis, degenerative scoliosis is not just cosmetically challenging but
causes significant pain and disability.
Treatment options for degenerative
scoliosis include medications, non-surgical treatment, and surgical options.
Medications primarily incorporate pain-killers that provide only symptomatic relief and do not cure the root cause of the pain making this treatment
option less acceptable. Nonsurgical treatment involves weight loss, bracing,
manual manipulation, nutrition and application of ice packs or heat. All these
methods (individual or combined) provide transient relief but are not adequate
to treat the root cause. When all the non-surgical treatment options have
failed to treat degenerative scoliosis, surgery can be considered as the
treatment option.
Scoliosis surgery is influenced by age,
medical comorbidity, previous surgical history. Evaluation of bone density
before surgery and comprehensive nutritional assessment are must before
scoliosis surgery. Reasons to prefer scoliosis surgery are as follows:
1. Maintain nerve function: Scoliosis
surgery is required to maintain body functions. (walking, bowel movements)
2. Mitigate agonizing pain: When
pain-killers and non-surgical treatment options fail to alleviate the torturous
pain
Surgical options fall in 3 categories:
1. Decompression surgery (e.g. lumbar
laminectomy): This procedure involves the removal of part of the vertebra and
other spinal elements to alleviate the pressure on the spinal cord and/or nerve
root.
2. Decompression with fusion surgery:
Decompression surgery alone in setting scoliosis curvature can make the spine
more unstable. Therefore, this technique involves decompression surgery with
fusion. Fusion refers to fuse the bones together to stabilize the spine. The fusion can be long for severe curvature and
short for moderate curvature.
3. Correction: This technique involves
the removal of discs between the vertebrae, and placing a cage or bones between
them.
Coming to the most critical part, the
success rate of scoliosis surgery, the internet is full of diverse opinions.
All surgeries have little or more risk involved such as bleeding or some sort
of infection. The people considering for degenerative scoliosis surgery are
above the 60s, hence the risk tends to be higher. As in this age group people
face several other medical considerations.
Medical conditions have got a
considerable influence on the success rate of surgical procedures. For
instance, individuals suffering from
osteoporosis can have failed fusion surgery due to weakened bones. The
individual with Kidney problems can have additional complications and delayed
recovery post-surgery.
However, some authentic sources claim to
have a success rate of 70%. University of Washington’s Department of
Orthopaedics and Sports Medicine says that the average curve correction with
spinal fusion in idiopathic scoliosis is roughly around 70%. The observation is
for surgery carried out on the individual below 16 years. The complications
rate is believed to be around 2-3% which includes complications like infection,
failed fusion and paralysis. However, as stated earlier the risk of
complication is very low. In the majority of cases, scoliosis surgery is done
without any complications. Successful in alleviating the symptoms and pain of
scoliosis, supporting the patient to get back to a normal routine.
Post-surgical back pain is
typically managed with exercises or other simple treatment options without the
need for medications. American
Academy of Orthopaedic Surgeons claims that
there has merely been 3-10% of patients
requiring revision surgeries or removal of instrumentation for ongoing back
pain over the period of 20 years. And this gives confidence to patients who are
in a dilemma for the surgical option. The success rate is believed to fetch
more and more patients to scoliosis surgery over other treatment options.
