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Scoliosis surgery in children

Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child

Scoliosis surgery repairs abnormal curving of the spine (scoliosis). The goal is to safely straighten your child's spine and align your child's shoulders and hips to correct your child's back problem.

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Description

Before surgery, your child will receive general anesthesia. These are medicines that put your child into a deep sleep and make them unable to feel pain during the operation.

During surgery, your child's surgeon will use implants, such as steel rods, hooks, screws, or other metal devices to straighten your child's spine and support the bones of the spine. Bone grafts are placed to hold the spine in the correct position and keep it from curving again.

The surgeon will make at least one surgical cut (incision) to get to your child's spine. This cut may be in your child's back, chest, or both places. The surgeon may also do the procedure using a special video camera.

During the surgery:

The surgeon may get bone for the grafts in these ways:

Different surgeries use different types of metal instruments. These are usually left in the body after the bone fuses together.

Newer types of surgery for scoliosis do not require fusion. Instead, the surgeries use implants to control the growth of the spine.

During scoliosis surgery, the surgeon will use special equipment to keep an eye on the nerves that come from the spine to make sure they are not damaged.

Scoliosis surgery often takes 4 to 6 hours.

Why the Procedure Is Performed

Braces are often tried first to keep the curve from getting worse. But, when they no longer work, the child's health care provider will recommend surgery.

There are several reasons to treat scoliosis:

The choice of when to have surgery will vary.

Surgery is often recommended for the following children and adolescents with scoliosis of unknown cause (idiopathic scoliosis):

Risks

There may be complications with any of the procedures for scoliosis repair.

Risks of anesthesia and surgery in general are:

Risks of scoliosis surgery are:

Problems that may develop in the future include:

Before the Procedure

Tell your child's provider what medicines your child is taking. This includes medicines, supplements, or herbs you bought without a prescription.

Before the operation:

During the 2 weeks before the surgery:

On the day of the surgery:

After the Procedure

Your child will need to stay in the hospital for about 3 to 4 days after surgery. The repaired spine should be kept in its proper position to keep it aligned. If the surgery involved a surgical cut in the chest, your child may have a tube in the chest to drain fluid buildup. This tube is often removed after 24 to 72 hours.

A catheter (tube) may be placed in the bladder the first few days to help your child urinate.

Your child's stomach and bowels may not work for a few days after surgery. Your child may need to receive fluids and nutrition through an intravenous (IV) line.

Your child will receive pain medicine in the hospital. At first, the medicine may be delivered through a special catheter inserted into your child's back. After that, a pump may be used to control how much pain medicine your child gets. Your child may also get shots or take pain pills.

Your child may have a body cast or a body brace.

Follow any instructions you are given on how to care for your child at home.

Outlook (Prognosis)

Your child's spine should look much straighter after surgery. There will still be some curve. It takes at least 3 months for the spinal bones to fuse together well. It will take 1 to 2 years for them to fuse completely.

Fusion stops growth in the spine. This is not often a concern because most growth occurs in the long bones of the body, such as the leg bones. Children who have this surgery will probably gain height from both growth in the legs and from having a straighter spine.

References

Negrini S, Felice FD, Donzelli S, Zaina F. Scoliosis and kyphosis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 153.

Warner WC, Sawyer JR. Scoliosis and kyphosis. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 44.

Yang S, Andras LM, Redding GJ, Skaggs DL. Early-onset scoliosis: a review of history, current treatment, and future directions. Pediatrics. 2016;137(1):e20150709. PMID: 26644484 www.ncbi.nlm.nih.gov/pubmed/26644484.

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Review Date: 11/5/2018  

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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