Scoliosis - Braces

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Adult Scoliosis. Due to the increase chance of complications, there is more reluctance to perform surgery on this patient group.

Procedures will differ depending on whether a child has idiopathic scoliosis, or scoliosis due to muscle and nerve disorders (such as muscular dystrophy or cerebral palsy). In the latter cases, children also need a team approach to reduce their risks for serious complications.

Preoperative Care

Before the operation, a doctor conducts a complete physical examination to determine leg lengths, muscle strength, lung function, and any postural abnormalities. The patient receives training in deep breathing and effective coughing to avoid lung congestion after the operation. The patient should also receive training in turning over in bed in a single movement (called log-rolling), before the operation. Psychological intervention, using cognitive-behavioral methods that help young patients cope, may be very helpful in reducing anxiety and pain after surgery.

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Patients are encouraged to donate their own blood before the operation, for use in possible transfusions. The patient should have no sunburn, rashes, or sores on the back before the operation. These conditions could increase the risk for infection.

Fusion

Most scoliosis operations involve fusing the vertebrae. The instruments and devices used to support the fusion vary, however.

In the fusion procedure, the surgeon will:

• Raise flaps to expose the backs of the vertebrae that lie along the curve.
• Remove the bony outgrowths along the vertebrae that allow the spine to twist and bend.
• Lay matchstick-sized bone grafts vertically across the exposed surface of each vertebra, being careful that they touch adjoining vertebrae.
• Fold the flaps back to their original position, covering the bone grafts.
• These grafts will regenerate, grow into the bone, and fuse the vertebrae together.