Scoliosis is an abnormal curvature of the spine. The spine might look like letter C or S. Often, the shoulder or hip relative to each other will appear irregular, one more upper-interior or anterior-posterior with respect to each other. When treating Scoliosis, a doctor will consider the severity of the person's curve, age and other physical conditions. Scoliosis surgery is recommended only in cases of severe curvature. Surgery is the best treatment option to correct curves greater than 45 degrees in a mature bone from the point of view, or vertebral curves that have not responded to other treatments. The main objective of Scoliosis surgery is to prevent the curve from worsening and to correct the vertebral deformity.
In contrast to open spine surgery, minimally invasive (IM) approaches are faster, safer, and require less recovery time.
Because the nerves, vertebrae and discs are located in the inner part of the body, any approach to reach them requires mobilizing the muscle tissue that lies along the way. In traditional open surgery this is done through large incisions and dissecting the insertions of the muscles to mobilize them, which means that many of them become unusable or permanently damaged.
Minimally invasive scoliosis surgery is not appropriate for every patient. It is usually used when scoliosis curvature lies in the thoracic spine. For thoracolumbar (mid to lower-back) curves and lumbar (lower back) curves, usually traditional open procedure is preferred.
Minimally invasive spine surgeries are performed with the help of special operative tools called Tubular Retractors. These are inserted through small incisions, right into the spinal column, creating a tunnel like opening to the area that needs to be operated on. The tubular retractor holds the muscles open and is kept throughout the procedure. This ensures that the blood loss and damage to the muscles, ligaments and bones are minimal, compared to open surgeries.
For the minimally invasive surgery, you’ll first be administered general anesthesia and put to sleep. You will be then be positioned on a radiolucent operating table, which allows the surgeon to take intraoperative X-rays of your spine with a fluoroscope positioned around you. This guides the surgeon in determining the correct position of the incision and also in instrument placement during the procedure.
- First, few small incisions are made depending on the location of the spinal curve, the number of levels to be fused and the viewpoints required to clearly visualize the spine for instrument placement.
- A thin membrane that lines the chest cavity is gently cut and pulled away to gain access to the spinal bones.
- Sometimes, even a portion of rib is also removed either to serve as a source of bone graft for fusion or to improve the patient’s aesthetic appearance especially with presence of a prominent rib hump.
- Disc material is removed from between the vertebrae involved in the curve. Removal of the disc material increases the flexibility of the curve and also provides a large surface area for spinal fusion.
- Screws are then fixed to the vertebrae to be corrected, guided by the images from the endoscope and fluoroscope.
- The bony surface between the vertebral bodies is roughened and bone graft or bone graft substitute is packed into the space between the vertebral bodies to promote fusion. The source of bone graft may include the removed rib, the crest of the pelvis or allograft (donor) bone.
- A specially contoured customized rod is then attached to the fixed screws at each vertebra. The screws are then tightened appropriately to achieve proper correction of the spinal deformity as possible.
- The endoscope and the retractor are pulled out and the incision is closed.
The spine looks much straighter soon after the surgery but some curve will still be there. Spinal bones take a minimum 3 months to fuse together. However, complete fusion usually takes one to two years depending on the procedure and your body’s ability to heal and firmly fuse the vertebrae together. Your surgeon may recommend you wear a brace after the surgery. To ensure a smooth and speedy recovery follow the home care instructions given by your doctor and the surgical team closely and diligently.
All treatments and therapies are performed by our associate Aster Medcity, Kochi, Kerala, India. Aster Medcity holds the responsibility of the treatment effectiveness and other services mentioned above.
After submitting your enquiry, you will be receiving a consultation over the phone, email or chat from an expert from Aster. The exact treatment procedure, patient qualification guidelines for the surgery, effectiveness of the surgery, do’s and don’ts before and after treatment, etc are communicated to you by the expert.
Before booking, you will be communicated the terms and conditions of the associate, which you have to agree for proceeding with the confirmation.