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Degenerative Scoliosis Surgery

Friday, March 20, 2020


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.

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