Spinal Fusion for the Treatment of Idiopathic Scoliosis in Children: Orthopedic Surgery to Treat Curvature of the Back in Children and Teenagers
Edited By: Kit M. Song, M.D.
Last updated Thursday, October 20, 2005
About the procedureWhat are the technical details of idiopathic scoliosis for idiopathic scoliosis? What is actually done? For posterior procedures, the spine is exposed after the
patient is positioned face down on a special frame. Then the patient’s X-ray is
used to guide the surgeon in placing hooks or screws into the vertebrae where
rods are later attached. The joints between the bones are removed and then the
spine is straightened by attaching rods to the hooks or screws. The spine is
then repositioned and the screws and hooks are tightened securely to the rod.
Usually bone grafts serve as scaffolding for new bone cells
to grow into. The bone graft can be taken from the patient or can be taken from
the bone bank. In children, either bone supply works equally well for healing.
It is advisable to discuss the options thoroughly with the surgeon and to
evaluate the pros and cons of either bone graft source.
The spinal cord is monitored throughout surgery to track
impulses up and down the spinal cord.
This is a precaution taken to add an extra margin of safety and to
decrease the possibility of cord injury.
Following surgery, a brace may be used for added support, depending on
the patient’s condition. In the majority
of cases (in 2005), braces were not used.
For anterior procedures, the patient is placed on his or her
side. An incision is made to the spine
either through the flank for the abdominal area or through the chest for the
thoracic area. Screws are placed into the bone and the discs between the
vertebrae are removed. Bone is then placed into these areas to help stimulate
bone healing in between vertebrae. A rod
is attached to the screws and the spine is straightened and locked securely
into position. Braces are often not used
after surgery.
After either anterior or posterior surgery, a tube is
typically left in to drain off any bleeding that occurs after the surgery. What is the typical anesthetic used for idiopathic scoliosis for idiopathic scoliosis? Monitoring of spinal cord function is done during scoliosis
surgery. The standard monitoring should include monitoring of the pathways that
transmit sensation and of the pathways that transmit motor movement. Most
patients are administered general intravenous (IV) anesthetic. A medication
called Propofol is often used along with pain medication and Nitric Oxide,
which is a gas to help sedate the patient and help him or her drift off to
sleep. The use of paralytic agents is often avoided due to the potential of
interfering with the spinal cord monitoring.How long does idiopathic scoliosis for idiopathic scoliosis usually take? The length of surgery depends on how much of the spine needs
to be fused and the approach that is used. Most anterior or posterior surgical
procedures take three to five hours. The actual time in the operating room is
longer than just the surgery because there is a need to apply monitors and
position the patient appropriately for surgery.
If a thoracoscopic procedure is performed, the length of time is a bit
longer then it is for a more conventional open approach. If a combined anterior and posterior spinal
fusion is performed, the surgery may take up to 8 to 10 hours.
Surgery for Idiopathic Scoliosis at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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