Surgery is often recommended once a scoliosis patient's spinal curve has progressed beyond a certain point, and in the vast majority of cases, 'surgery' means spinal fusion surgery. This procedure involves joining two or more vertebrae together to prevent the patient's curvature from growing; nowadays, this is usually achieved by fastening small metal screws called pedicle screws to the spine, then using a bone graft to 'fuse' the vertebrae together
However, while this procedure is still the standard surgical scoliosis treatment method in most parts of the world, there are a number of risks associated with spinal fusion. Though rare, the potential complications include:
- Screws placed in the wrong positions
- Screws breaking or coming loose
- Dural lesion
- Various neurological, pulmonary, and vascular complications
In response to the risks sometimes associated with spinal fusion, a number of other surgical scoliosis treatments have been developed, and some of these new techniques seem to becoming increasingly popular. Today, we'd like to look at three relatively new surgical procedures and why they're potentially preferable to spinal fusion surgery.
Magnetically-controlled growing rods (MCGR)
Magnetically-controlled growing rods are already being used in more than 20 countries (including the UK and the USA) to treat scoliosis in children under the age of seven. During the MCGR procedure, the surgeon fastens titanium rods to the patient's spine; these rods have a lengthening mechanism that can be operated magnetically, and after the operation itself, the patient attends a series of minimally-invasive 'distraction' procedures where a remote controller is used to lengthen the rods and correct the spinal curvature.
This effectively puts the doctor in control of the child's scoliosis until they have finished growing.
Stapling and tethering
Vertebral body stapling (VBS) and vertebral body tethering (VBT) are two minimally-invasive procedures that are usually performed on scoliosis patients who are still growing (e.g. teenagers and pre-teens). VBS uses malleable metal staples to join two or more vertebrae together, while VBT uses pedicle screws attached to a flexible cable at the site of the curvature. VBS is recommended for thoracic curves of 25-35 degrees and lumbar curves under 45 degrees; VBT can be used to treat thoracic curves between 35-70 degrees.
Currently available only in the UK, the USA, India, Canada and New Zealand, the tethering and stapling procedures have no major reported complications and are generally less invasive than the more commonly-seen spinal fusion procedure.
Apifix is a small implant that is attached to the spine using just two screws. No fusion is performed, and the procedure is not very invasive, leaving a far less visible scar than spinal fusion surgery.
This procedure is ideal for adolescents with idiopathic scoliosis, especially where the curve measures 40-60 degrees. Apifix is currently available in the USA, Israel, and across Europe.
Any surgery carries risks and complications, depending on the procedure and patient presentation. If you are looking for a non-surgical alternative to spinal fusion, please contact the Scoliosis SOS Clinic today. We use an exercise-based regime called ScolioGold to correct scoliosis without any surgical intervention whatsoever. We can also assist with recovery after undergoing scoliosis surgery.