My Spine - Lumbar
Posterior corrective fusion
This is the commonest option employed in the management of scoliosis. The
spine is exposed from behind, by stripping the muscles to the side. Hooks and
screws are fixed into the spine. This carries some risk as they are close to the
nerves.
Once the connection points are placed, the facet joints are resected from the
spine to encourage a fusion, in other words the formation of a solid bony
bridge. Two rods are then applied, one on the left and one on the right. The
rods are attached to the connectors in a sequential fashion, forcing the spine
into a straight line. This corrects the scoliosis.
These interventions are considerable and a patient can expect to stay in hos-
pital for seven to ten days including one to two nights in the High Care Unit.
Blood transfusions are generally required. The first few days following sur-
gery are extremely painful and morphine type medication is required which
may cause nausea and drowsiness.
Risks of scoliosis surgery
All surgery brings risk. The general risk of infection is present, but relatively
low at around 0,8%. It is even lower with the anterior approaches. There is
a risk of non-union, or failure of the bone to grow together (fuse). Should
this occur, the instrumentation will probably fatigue and break at around
12-18 months post-operatively with pain and a loss of correction.
The risk most feared is neurological injury (paralysis). Although this risk is
ever present, it is rare, with a chance of 1:300 of any neurological event rang-
ing from some numbness to total paraplegia (unable to move or feel legs).
This can occur from the corrective process and increased strain on the spinal
cord or from reduced blood supply to the cord.
To reduce the risk of neurological damage, some surgeons use spinal cord
electrical monitoring during the procedure, although this is not fail-safe and
has its own technical challenges. Should there be a problem in the immediate
post-operative phase, urgent instrumentation removal may be required.
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