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What Is Scoliosis?
Scoliosis is a sideways curve in your backbone (or spine). Often, it first shows up when you're a child or teenager. The angle of the curve may be small, medium or large. But anything that measures more than 10 degrees on an X-ray is considered scoliosis. Doctors may use the letters "C" and "S" to describe the curve. Normally small curve is less than 60 degrees, medium between 60-90 degrees and large is more than 90 degrees. scoliosis may be as a result of Bony defect (called as congenital scoliosis) or as a result of nerve or muscle problem (called as neuromuscular scoliosis) or there may not be any underlying pathology at all.(called as idiopathic scoliosis. )
Kyphosis
Kyphosis is a spinal condition in which, the spine curves forward more than it should ( more than 60 degrees). As a result, the upper back looks overly rounded. The curvature can make people looked hunched or slouching. People sometimes call it ‘hunchback’ or ‘round back’. It is mostly because of infection or some fracture or some form of Bony abnormality like fused vertebra or incompletely formed vertebra in the spine. Sometimes kyphosis can be because of age related weakening of the vertebras and age related Bony fractures in the spine.
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Kyphoscoliosis
Kyphoscoliosis is a combination of outward curvature (kyphosis) and lateral curvature (scoliosis) of the spine. .
Proven methods to fully correct spine deformities
Common treatments for spinal deformity from non-surgical to surgical include:
- Observation and monitoring, particularly in young children, to ensure the spinal curvature does not progress. This is usually done if the child is less than 10 years of age and the curve angle called as cobbs angle is less than 40 degrees.
- Bracing to hold the spine in alignment. bracing allows the curve to correct slowly or hold the curve in same position till the final surgery is done.
- Physical therapy and lifestyle changes to include more exercise in order to strengthen back muscles. Children are encouraged to do back and abdomen exercises to keep the muscles around the spine strong. This is very important for holding the curve incorrect position before surgery and after surgery it helps in early mobilization of the kid.
- Finally surgery is the ultimate solution if the curve is of congenital origin or is more than 40 degrees in case of neuromuscular or idiopathic variety. Fusion surgeries include procedures like putting screws and rod along with cutting the bone as specific positions called as osteotomies or vertebral column resection to strengthen the spine.
Surgery for a spinal deformity can range from minimally invasive to very complex. the length of surgery may vary from 4 hours to 14 hours depending on the complexity of curve and the correction required. some Times the surgery is done in 2 stages, 3 days apart if the surgery includes cutting the bone at the apex of the curve called as vertebral column resection .
- For Children with scoliosis since birth (congenital): 3-5 years of age.
- For children (Adolescent idiopathic scoliosis ) : between the ages of 11 and 13 years for girls and between the ages of 13 and 15 for boys.
- For adults : Any age whenever the deformity presents
- For neuromuscular scoliosis: Normally after the age of 10 years
FAQs
1) What age is best for scoliosis surgery?
2) Is it a major surgery ?
scoliosis surgety is typically classified as a major. Surgery lasts between 6 to 8 hours.
3) How long is the recovery timeline?
Patient start walking the next day. But they have to wear brace and refrain from active exercises for nearly 3 months. Sports can be started at 6 months. Patient may experience some pain up to 3 weeks of surgery. Most of the patients are pain free by the end of first month. Patient is not allowed to bend forward and lift heavy weight up to 3 months after the surgery. Most of our patients are able to get back to active and healthy life by the end of 3 months.
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Scoliosis Surgery Recovery Timeline
Every patient’s recovery journey is different, so take this timeline with a pinch of salt and listen to your surgeon – they’ll give you the best idea of what to expect in the weeks and months following surgery.
First 7 Days After Surgery
Generally the patient gets discharged from the hospital within 3-7 days if there are no complications.
Although they need rest for a few initial days, your physiotherapist would assist you to make you stand and walk for a short distance on the very next day of surgery, followed by which, you should be able to perform some small daily tasks that don’t require bending or lifting within a week!
At home instructions are given at the time of discharge from the hospital including the schedule of exercises, diet plan, medications etc.
1 To 2 Weeks After Surgery
Normally with good wound care, the sutures are removed after 2 weeks from the date of surgery. This is the time when the dressing can be taken and and the patient can have a proper bath.
At the same time, to prevent infection, it is important to keep the area dry and clean.
3 To 4 Weeks After Surgery
With efficient physical therapy and rehabilitation, most of the children would go back to schools and adults can start their office work too, with some limitations to be kept in mind, for example – avoid vigorous activities like running, jumping, lifting heavy objects, etc.
Light exercises as per the scheduled shall be continued.
6 To 12 Weeks After Surgery
Around 6 weeks post-op, is the time to step up the exercise plan after a proper consult with your surgeon and the physiotherapist.
You might need an Xray at this stage if indicated.
6 Months To 12 Months After Surgery
At this stage you must see your surgeon for a final recovery status, and most of the patients can resume nearly all activities (including contact sports) between 6 and 12 months after surgery. This solely depends and varies with every patient.
Recommendation: Always consult your doctor before starting or resuming contact sports and other more extreme activities, such as rock climbing or bungee jumping.
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4) How painful is the procedure?
Surgery is painful for first two days and after that the pain gradually starts reducing. Normally the patient is pain free after 3 weeks.
5) Will my pain increase if I don't opt for scoliosis surgery?
As per the studies people who didn't undergo scoliosis surgery had more pain than people without scoliosis in long run. However, the pain was generally rated as occasional. It did not interfere with working life or with daily activities after surgery.
6) What about my flexibility after scoliosis surgery ?
To minimize pain and discomfort after scoliosis Correction surgery, I advise my patients to bend at the knees and hip as opposed to using their back.
7) What if I avoid surgery for too long ?
Moderate to severe scoliosis if left untreated can lead to pain and increasing deformity with age. It can even lead to potential heart and lung damage.8) At what stage of life does scoliosis increase rapidly ?
Since Scoliosis is a sideways curve of the spine with rotation element. It grows most rapidly during the growth spurt just before puberty. (10-15 years).
9) What is the success rate of scoliosis surgery? ?
So far in our hands the success rate is almost 100%. We have not had a single case ending in paralysis so far. The surgical correction of the curve is between 80% to 100%. And patient satisfaction rate is close to 100%.).
10) What are the types of scoliosis?
- Congenital: since birth due to Bony defects.
- Neuromuscular : may be present since but aur may develop letter due to muscle imbalance.
- adolescent idiopathic scoliosis : most common type of scoliosis. Without any obvious call. But can lead to bony changes and muscle imbalance in long run.
- Adult denovo scoliosis : occurs because of age-related degeneration in disc and spine joints.
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11) When can I walk after my scoliosis surgery?
All of our patients start walking the next day of surgery. normally the patients become independent in their activities by two weeks of surgery
12) What if I undergo scoliosis surgery as an adult? ?
surgery in adulthood for scoliosis may not eliminate all symptoms. But in high percentage of cases it can effectively balance the spine, relieve scoliosis symptoms, and improve overall quality of life.
13) Can I get paralyzed under scoliosis surgery?
There is a a small chance of paralysis during scoliosis surgery. But we routinely use neuromonitoring and 3D bone reconstruction during all our scoliosis surgeries. This gives us almost hundred percent success rate in all our surgeries.
14) What side effects can happen after surgery ?
- Repeat surgery.
- RCurve progression
- RSkin related issues.
- RImplant related issues.
- Pain
15) Do I need to wear a brace after surgery ?
Yes for full three months after surgery.
16) Does scoliosis affect life expectancy?
Not directly. But yes, surgery can improve it.
17 )What happens if I bend after spinal fusion?
You will not be allowed to bend forward for 3 months after scoliosis correction surgery. However after 3 months you will be taught spinal exercises and ways to bend forward.
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18) Why do adults get scoliosis?
Degeneration or aging of the discs and joints of the spine occurs asymmetrically, causing tilting and even slipping between the vertebrae. As this cascades from one level to the next, a curve of the spine can develop. This form of scoliosis primarily affects the lumbar spine.
19) Does it pain after scoliosis surgery?
Pain is maximum within two days of surgery. however the pain goes on decreasing slowly post surgery in majority of the patients. Mostly patients are comfortable after 2 weeks of the surgery. pain totally vanishes around three to four weeks after surgery.
20) What should I avoid after scoliosis surgery?
- Playing football and other high-contact sports.
- Ballet and gymnastics.
21) Can I have a normal life after scoliosis surgery?
Majority of the patients have a normal life after scoliosis surgery in terms of walking, running, sitting, standing ,sexual activities, driving and recreational stuff.
22) What about jogging and running after scoliosis surgery ?
Jogging and running are fine for most people with scoliosis after 8 months of surgery
- Lung problems that include difficulty in breathing due to severe curvature of the mid-back ,pressing onto the lungs and giving limited space to the lungs for expansion .
- Inability to perform activities of daily living, such as walking or dressing, due to postural problems from a curved spine. This can be made worse by progressive nerve and muscle weakness in the pelvis and lower limbs over a period of time.
- Loss of sensation in the legs, incontinence, or reduced sexual function due to nerve compression in the lower back . It is important to understand here that in case of large curves which are over 100 degrees in cobb's angle measurement this type of progressive paralysis eventually develops over a period of time. Sometimes it can develop very rapidly over a period of few months in case of kyphoscoliotic deformity of spin specially as a result of traumatic or infective primary pathology.
- Pain due to compressed spinal nerves or muscle spasms. slowly as the curve progresses eventually pain developes at the back in all types of scoliosis due to degeneration of facet joints and disc in the spine.
- Extreme cases of curve angle more than 140 degrees may cause the curved spine and the ribs to start pressing the internal abdominal organs also leading to difficulty in eating and digestion, and frequent symptoms like vomiting and abdominal pains .
What Will Happen If You Delay The Treatment.
Potential Complications Of Delayed Surgery Or Not Going Ahead With The Surgery Includes :
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