Introduction
Scoliosis is a common phenomenon which means an abnormal curvature of the spine. In many cases, especially in adolescents, the basis is a genetic one. However, some neuromuscular disorders, for example muscular dystrophy, can be the cause of scoliosis.
In addition, asymmetric spinal disc degeneration can also cause an abnormal curvature in the spine, and this happens primarily with adults. To correct scoliosis, in most cases the solution includes placing multiple screws along the curve with special instrumentation used to decrease the curvature. Bone grafts or substitutes can be added in order to fuse the vertebrae with the adjacent normal spine.
Incision & Instrumentation
The surgeon makes a long incision to the middle of the back. The spine is then exposed, and using surgical instruments, the surgeon prepares for the nest step. Holes are drilled in the pedicle of vertebrae, on both sides of the area. Screws are inserted into the holes. Then metal rods are put in between the screws and fixed in place. These rods are rotated in a manner that causes the spine to straighten. This special instrumentation is used to prevent the vertebrae from moving at the time when bone graft fusion is created.
Bone Graft
Bone grafting can be performed using the patient’s own bone, which is called autograft, a bone graft synthetic substitute, or a processed bone from a bone bank which is called allograft.
In order to install a patient’s own bone for the grafting, another incision is made in the back of the pelvis. The bone is taken from the iliac crest and positioned along the prepared sites on the spine, after the layer of bone was removed for the fusion. Eventually grafts grow in place of the original, fusing the spine elements to provide stability.
Closure
Surgical correction cannot correct 100% of the abnormality. It can reduce scoliosis spinal curvature by up to 50 percent. A brace sometimes needed after surgery. If bone graft is taken from the pelvis, some pain can be expected at the site for a short while.