As most scoliotic curves are in the thoracic spine, only a posterior (back) rather than anterior approach is possible. Surgery is done through an incision on the back of and the entire length of the thoracic spine.
After incision, the muscles are then stripped off the spine, exposing the bony elements in the spine. The spine is then instrumented with screws and rods to reduce the amount of the curvature. Bone is then added, (either the patient’s own or bone morphogenic protein, a bone substitute), to stimulate spine fusion, a process which usually takes about 3 to 6 months, and can continue for up to 12 months.
Severe spinal deformity and/or very rigid curvature may first require an anterior release of the disc space (removal of the disc from the front) either through an open incision or with a scope (thoracoscopic technique). Removing the discs allows for a better reduction of the spine and also results in a better fusion. This is especially important if the patient is a young child and has a lot of growth remaining. If just the posterior portion of the spine is fused, the anterior column can continue to grow, and loss of reduction can result. Anterior fusion of the spine prevents this process.
Post surgery you may need to wear a brace, this will be fitted to you specifically and worn when you are sitting or mobile. Sometimes your surgeon will recommend that you wear a corset when sitting or mobile.
You will need to build your walking and sitting stamina over the 3 – 6 months following your surgery.
Do not lift anything over 3kg in weight. You must not bend or twist until advised otherwise and may only resume driving when safe to do so.
© St. Joseph's Hospital 2019