Below is a picture of a patient with a 60 degree thoracic curve, and a 47 degree lumbar curve. They underwent spinal fusion, and the picture beside it shows the x-ray following the surgery.
As you can see, the surgery limited the curve to only 15 degrees all together.
The main point of the spinal fusion surgery is to fuse the vertebrae together to limit the degree of curvature within the spine. When it comes to juvenile idiopathic scoliosis, currently instrumentation such as rods, screws, hooks or wires are a successful way at lowering the amount curvature in the spine and keeping it in the same place.
Following spinal fusion surgery, patients are not allowed to twist their back, and recovery can take up to a year. They're also not allowed to bend over at the waist, such as reaching for their toes.
Today I got to see a patient recovering from spinal fusion surgery, a little less than two months out of their surgery. It was interesting to see a patient beginning their recovery, as the only recovery I had been able to see in such depth beforehand was myself.
The following image is a side view of what instrumentation such as screws look like in an x-ray of a patient.
Although the screws may look painful, they usually do not cause any sort of pain in the patient, such as poking, which many people may imagine due to how the screws look.
When it comes to pediatric scoliosis spinal fusion, the threshold to require spinal fusion is 50 degrees or above, however curves between 45 and 50 degrees may also have surgery if justified by the surgeon, such as for aesthetic reasons.
The other main treatment for scoliosis is a back brace, but this is only affective and useful in patients who are not done growing, as normally the curve stops increasing when the patient stops growing. The brace is used to limit the growth of the curve, not lessen the curve.
I'm very excited to see more examples of this surgery and start my research about the complications that may follow such a surgery, as all of this is very close to me personally.
The way they use screws to realign the spine is really interesting! I actually did assume that the screws would be felt by the patient. With that being said, do the screws and rods prevent the patient from doing certain things? Or do they possibly change the way patients can move their back multiple years after their surgery?
ReplyDeleteHaving the screws in their back, or the rods, does prevent certain movements, such as bending backwards or forwards. Although it is possible for patients to be able to do these movements, doctors do not suggest it.
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