Scoliosis Surgery

Earlier this year, we answered some frequently asked questions about scoliosis surgery to provide you with more information on the spinal fusion procedure that is often used to correct severe spinal curves. Since then, we've been asked a number of other questions about this operation, so we thought we'd assemble another list of frequently asked questions to give you a little more insight into what scoliosis surgery is really like.

Q. Does scoliosis surgery hurt?

A. You won't experience any pain during the surgery because you'll be under general anaesthesia, but you may experience some discomfort after the operation. While you recover, you will be given PCA (patient-controlled analgesia) - a pump that delivers morphine or other painkillers into your system when you press a button. This will control the pain for the first few days after surgery.

Most patients are moved off PCA after 2-3 days and then begin a course of oral pain medication. When discharged from hospital, a prescription for pain medication is provided. In most cases, children are usually off medication within two weeks; however, adults may require medication at diminishing doses for weeks or even months after surgery.

Q. Does scoliosis surgery leave a scar?

A. Yes, you will be left with a scar but it will gradually fade over time. The length of the scar depends, at least in part, on how many curves there are in your spine. If you have just one spinal curve, your scar should be roughly 10 inches long. However, if you have two or more curves in your spine, your scar may begin in the middle of your shoulder blades, and may finish as far down as your pelvis. Surgeons will try to keep the scar as thin as possible by placing the sutures beneath the skin. Some surgeons may even use a special type of glue that promotes wound healing.

Q. Does scoliosis surgery make you taller?

A. Yes - but the length of your spine will not have changed. The increase in height is due to your spine being straightened and therefore appearing longer. The increase in height depends on the severity of your spinal curve.

Q. What kind of doctor performs scoliosis surgery?

A. Both orthopaedic surgeons and neurosurgeons can carry out a spinal fusion procedure. Scoliosis surgery was originally carried out exclusively by neurosurgeons, but nowadays, orthopaedic surgeons are equally well-qualified to undertake the majority of spinal operations.

Q. How long does scoliosis surgery take?

A. The spinal fusion procedure tends to take 4-6 hours, but the time can vary between patients. The surgeon will take as long as necessary to ensure the patient receives the best results.

Q. Can you exercise after scoliosis surgery?

A. Yes - in fact, exercise helps with the rehabilitation process. Physical therapy is encouraged as it stretches and strengthens the muscles around the spine, and also improves neuromuscular stability. However, it is recommended that you don't do anything too strenuous, as it could worsen your condition.

Further reading:

Scoliosis SOS is a UK-based clinic providing non-surgical treatment for scoliosis and other curvatures of the spine. Click here to learn about our treatment methods, or get in touch to arrange an initial consultation.

Magnetic Growth Rods

Spinal fusion is the most commonly-used surgical treatment for scoliosis, but there are other procedures that can be used to combat a curvature of the spine. The use of magnetic growth rods is becoming more widespread - but exactly what does this procedure entail?

What are magnetic growth rods?

The magnetic growth rods procedure is relatively new, and it has been developed to improve the traditional growing rod procedures. Usually recommended only for young patients, the procedure is performed in an outpatient clinic under the control of an externally-applied magnet control device. It has shown itself to be a relatively safe and effective procedure, and only requires a short-term follow-up.

Magnetic growth rods aim to control the patient's spinal curve during the growth and development stage, until the patient nears skeletal maturity (after 11-13 years of age).

The procedure itself consists of single or dual titanium spinal rods that contain a magnetically drivable lengthening mechanism. These rods are inserted at the two most cranial levels and the two most caudal vertebral levels for distal fusion segments. Pedicle screws are used as anchors before passing the rods subcutaneous/submuscular to connect to each fusion segment. Patients are required to undergo a post-op procedure (distraction) after the initial surgery is complete.

What happens during the post-op procedure?

The post-op procedure is not very invasive, and patients are required to undergo follow-ups for 6 weeks for distraction. An external remote controller is placed over the internal magnet, and once applied, the rotating mechanism causes the rods to lengthen, thus distracting the spine. During each distraction visit, the aim is to lengthen the spine by 1.5 to 2mm. If the patient is experiencing any pain or discomfort, the device can retract. The procedure is pretty quick, and tends to last around 30 secs to a minute. This procedure is usually performed on children under the age of 7 that have been diagnosed with early onset scoliosis.

What complications can arise?

There are fewer complications associated with magnetic growth rods than with other scoliosis surgeries, but that doesn't mean there aren't any risks involved. There is a small chance that the rod may break and cause some damage to your spinal cord. There is also a risk that the pedicle screws may come loose and pull out, and on rare occasions, the device may also fail to construct a distraction. MAGEC rods are expected to last for approximately 24 to 36 months before they have to be replaced, at which point you will have to undergo surgery again.

How can we help?

If you don't want your child to undergo this type of scoliosis surgery, or if you're looking for something to help with the rehab process, the Scoliosis SOS Clinic can help! We treat all of our patients non-surgically, treating their conditions using an exercise-based treatment method that provides unrivalled treatment success.

Please feel free to contact us to find out more about our unique treatment method, or to book an initial consultation.

Scoliosis Height

From digestive problems to fatigue, scoliosis (a sideways spinal curvature) can affect the body in all sorts of different ways. For instance, have you considered the effect that a spinal curve might have on a person's height?

If your scoliosis is relatively mild, it won't have much of an impact on how tall you are, but severe scoliosis can result in a loss of height. Many scoliosis patients are shorter than they would be if their spines were straight, and while this particular symptom isn't as potentially life-altering as the chronic pain and loss of mobility that sometimes accompany a curvature of the spine, it is another reason to get your scoliosis treated - especially if your condition is progressing (getting steadily worse).

Is it possible to reverse this loss of height?

Since the impact of scoliosis on your height is directly linked to the severity of your spinal curve, this issue can be reversed through effective scoliosis treatment. A patient who undergoes spinal fusion surgery may well notice a height increase post-op because the procedure has made their spine straighter.

But surgery isn't the only way to regain the height you've lost because of scoliosis. Exercise-based treatments like our own ScolioGold programme can also be very effective in that regard.

Case study: Nicole from Accra, Ghana

Nicole was 12 years old when she was diagnosed with scoliosis. By that time, her brother was already living with a fairly serious spinal curve, and Nicole's parents were keen to ensure that her condition didn't reach the same level of severity.

However, Nicole did not meet the requirements for surgery (that is, her Cobb angle measurement was not high enough), so her family set about researching other treatment options online.

And that's how they came across the Scoliosis SOS Clinic. Nicole and her brother made the 3,000+ mile journey from Accra to London in order to attend a two-week ScolioGold course, and the results were very positive indeed: not only had Nicole grown taller, she also felt more confident in herself after completing her treatment. Watch the video below to find out what Nicole had to say about her Scoliosis SOS experience.

If you are looking for an effective scoliosis treatment option that doesn't involve surgery, we at the Scoliosis SOS Clinic can help. Click here to learn more about our ScolioGold programme, or get in touch to arrange a consultation.

Scoliosis SOS Physical Therapists

We at the Scoliosis SOS Clinic are very proud to announce that we recently had our first piece of research published in a peer-reviewed scientific journal. The article, Current knowledge of scoliosis in physiotherapy students trained in the United Kingdom (Black et al, Scoliosis and Spinal Disorders 2017) was published online on the 27th September and can be read in full here.

What were we researching?

Put simply, we wanted to know how much UK physiotherapists know about scoliosis. In both Poland and the USA, it has been recognised that physiotherapy students have relatively little knowledge of idiopathic scoliosis, how it affects the human body, and how to factor a spinal curve into a patient's treatment regime; with that in mind, we wanted to measure UK students' familiarity with this condition.

To do this, we composed a 10-question survey and distributed it (via course leaders) to students at all UK universities that offer physiotherapy degrees. Questions on the survey included:

  • What is the definition of idiopathic scoliosis?
  • What causes idiopathic scoliosis?
  • When does idiopathic scoliosis commonly develop?
  • What percentage of scoliosis cases are idiopathic?
  • What physical activities are most/least beneficial for patients with scoliosis? (multiple choice question - options included yoga, swimming, martial arts, etc.)

In the end, a total of 206 students at 12 different institutions in England, Wales, Scotland and Northern Ireland completed our survey, giving us a good sample size to analyse.

What were our findings?

Of the students who responded to our survey:

  • 79% successfully identified when idiopathic scoliosis commonly develops
  • 54% knew when bracing is recommended
  • 52% correctly identified that the causes of idiopathic scoliosis are not known
  • 24% recognised that scoliosis is idiopathic in approximately 80% of cases
  • 12% knew the criteria for diagnosing idiopathic scoliosis
  • 7% were able to recognise the best treatment approach through physical therapy

Overall, just 7% of students surveyed were able to answer more than half of the questionnaire correctly. Based on this, our conclusion was that there is a clear lack of scoliosis knowledge among UK physiotherapy students - a lack of knowledge that has the potential to impact patients who receive information and treatment from physiotherapists in this country.

Click here to view more scoliosis research, or visit our ScolioGold page to learn about the exercise-based scoliosis treatment we provide here at the Scoliosis SOS Clinic.

Spinal Tethering & Stapling

Many of the patients we treat here at the Scoliosis SOS Clinic come to us in search of an alternative to scoliosis surgery, but while our ScolioGold method has consistently proven capable of reducing spinal curvature and improving quality of life (thus eliminating the need for surgical intervention), our exercise-based therapy has on occasion been used in conjunction with surgical treatment when the case called for it.

The most common form of scoliosis surgery is spinal fusion, but there are a number of other techniques in use, and some of these have seen a boost in prominence and popularity of late. One approach that you might have heard of is spinal tethering, which comes in two different varieties: vertebral body stapling and vertebral body tethering.

What is vertebral body stapling?

Vertebral body stapling (VBS) is a less invasive alternative to spinal fusion surgery. This procedure aims to control the progression of the patient's spinal curvature through the use of special metal staples, which are attached to the vertebrae in the curved part of the spine. This creates a sort of internal scoliosis brace - the staples restrain one side of the spine while allowing the other side to grow normally, thereby countering the progression of the curvature.

VBS may be used to treat a thoracic spinal curve measuring 25-35 degrees, or a lumbar curve of under 45 degrees.

What is vertebral body tethering?

Vertebral body tethering (VBT) uses pedicle screws instead of malleable metal staples. These screws are inserted into the affected vertebrae and attached (tethered) to a flexible cable at the point where the spine curves. This procedure was developed with larger spinal curves in mind.

VBT is used in cases of scoliosis where the curve measures 35-70 degrees.

Benefits of spinal tethering

Both VBS and VBT are preferable to spinal fusion surgery in a number of ways:

  • These procedures are less invasive than spinal fusion

  • No major complications are currently associated with VBS/VBT

  • Spinal fusion is generally only available to scoliosis sufferers who have reached maturity and finished growing; VBS and VBT, by contrast, are recommended for young patients who are still growing

Is spinal tethering effective?

On occasion, a scoliosis sufferer will come to the Scoliosis SOS Clinic in order to improve their flexibility and spinal correction ability before undergoing spinal tethering surgery. Then, after their VBT/VBS procedure, that individual will return to us as a post-surgery patient on a modified programme that's designed to aid with scar tissue management and general rehabilitation. Our treatment programme also helps to prevent future progression of the patient's condition.

We have treated a number of post-VBT/VBS patients this way, and in our experience, spinal tethering/stapling has no positive impact on spinal rotation. This means that cosmetic changes to the patient's rib cage are minimal, so be sure to take this into consideration when weighing up your scoliosis treatment options.

It's also worth noting that VBT/VBS are not currently available in the UK due to a lack of research. At time of writing, these procedures are only being carried out in the USA, Canada, New Zealand and India, and many scoliosis patients have had to pay hundreds of thousands of pounds to undergo spinal tethering abroad.

Interested in non-surgical scoliosis treatment? Contact Scoliosis SOS today to arrange a consultation.

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