Scoliosis is a spinal deformity, usually congenital, in which the spine is unnaturally deformed. In addition to misalignment and pain, this spinal deformity can also affect the internal organs. If conservative therapies, such as physiotherapy and brace therapy, are no longer sufficient, scoliosis surgery is required.
Here you will find selected specialists for scoliosis surgery and further information.
Spinal disorders such as scoliosis can be treated conservatively with physiotherapy and a special corset. In the case of severe curvatures and increasing deterioration, however, scoliosis surgery is necessary. As this operation is not a simple procedure, it should be performed by a specialist in scoliosis surgery.
Scoliosis is a chronic spinal disorder in which the spine is curved sideways and the vertebrae are twisted. If the spinal deformity is not treated, it worsens over time. As a result of this spinal deformation, patients develop pain and restricted mobility.
Visually, scoliosis can manifest itself by one shoulder being lower or one shoulder blade protruding further. Scoliosis is also characterized by deformation and shortening of the trunk. As a result, severe spinal deformity can lead to impairment of the internal organs. This in turn has a negative effect on the cardiovascular system and lung function (shortness of breath, heart problems, etc.).
Left: Schematic representation of scoliosis. Right: Healthy spine © Koterka Studio| AdobeStock
The cause of this spinal disorder is unknown in most cases. As a rule, it is a congenital malformation of the spine.
Spinal disorders belong in the hands of an experienced specialist. Scoliosis surgery specialists are often specialists in orthopaedics, pediatric orthopaedics or spinal surgery. Scoliosis surgery is not a simple procedure. Therefore, scoliosis surgery should only be performed by surgeons / orthopaedic surgeons who have the appropriate experience in scoliosis surgery.
As scoliosis is usually a congenital deformity of the spine, children and adolescents already show the first signs of spinal deformity. This spinal deformity is not usually particularly pronounced at a young age. However, it increases significantly as the spine grows. It is therefore important that the diagnosis is made early in childhood and adolescence.
The clinical examination is particularly important in the diagnosis of spinal disorders. An experienced doctor can determine whether the patient is suffering from spinal deformity scoliosis through physical examination. To do this, the patient bends forward and lets their arms hang down. The doctor now looks over the patient's back and recognizes the onset of scoliosis from asymmetries. Among other things, the doctor checks
If the doctor finds an indication of a spinal deformity, an X-ray examination will follow. An X-ray image of the entire spine from the front and from the side shows the extent of the spinal deformation. From this, it is then also possible to deduce the extent to which the spinal deformation will worsen in the future and what treatment will be required. As an X-ray examination is always associated with radiation exposure, this examination should not be carried out at too close intervals. A lower radiation dose can also be used to measure the angle of curvature.
In specialized centers, alternative methods such as computer-assisted three-dimensional light-optical measurement(video raster stereography) of the back profile are also available.
The treatment of spinal disorders such as scoliosis depends on the severity of the spinal deformity and the patient's age. If the congenital deformity of the spine is only slightly pronounced, no treatment is usually necessary.
In order to prevent further progression of the spinal deformity, physiotherapy (physiotherapy) is necessary from a certain degree of deformity.
In addition to physiotherapy, the scoliosis specialist may recommend corset therapy. This uses an individually fitted corset to prevent further deterioration until the end of growth. It should even improve the existing curvature.
Scoliosis surgery is recommended for a very severe degree of curvature of over 45°. Scoliosis surgery is advisable if:
Such scoliosis surgery may be necessary even in children with a very severe spinal deformity. Early intervention also prevents the spinal curvature from worsening.
The aim of the operation is to straighten the spine and reduce pain.
Various procedures are available for the surgical treatment of scoliosis. In principle, two surgical approaches are possible:
Which approach is chosen depends on the individual case.
The advantage of ventral scoliosis surgery is the shorter stiffening distance, but the disadvantage is that the rib cage has to be opened. The ventral approach is also only possible for special curvatures in the thoracic or lumbar spine.
The surgeon therefore usually chooses the dorsal approach for scoliosis surgery. Thanks to the continuous improvement of surgical techniques in the dorsal approach, the stiffening distance is not significantly longer today and the results are similarly good as with ventral scoliosis surgery.
A special form is the mini-thoracotomy. Doctors make a short incision of 7-8 cm on the right side of the ribcage and operate between two ribs. In women, the incision is made under the right breast fold so that the scar, which is barely visible anyway, is hidden by the breast. This approach is possible for idiopathic scoliosis with a curvature of less than 70°.
Regardless of the approach, a metal screw-rod system is inserted to correct the spinal deformity. After the procedure, the vertebrae should grow together(spondylodesis) so that the spine is stabilized in the long term. Without the fusion, the rods and screws would loosen again after some time. However, this stiffening restricts the mobility of the spine.
Left: X-ray image of scoliosis. Right: After scoliosis surgery with inserted rods and screws © stockdevil | AdobeStock
For patients who are still in the growth phase, non-fusion techniques can also be used depending on the case. This prevents the bones from growing together.
Magnetic Magec rods are used, for example, which can be lengthened by further interventions as the patient grows. Another non-fusion procedure is the VEPTR (vertically expandable titanium rib prosthesis). The inserted rods are then attached to the ribs, not to the spine.
A corset is generally no longer required after scoliosis surgery.
The duration of the recovery phase depends on the individual case, for example on
In most cases, however, patients have recovered sufficiently after a few days to be able to stand up and walk around again. They can leave the hospital about a week after the scoliosis operation. However, the hospital stay is followed by a rehabilitation phase lasting several weeks. Sport is only possible again a few months after the operation.
The surgical scars usually heal well and are barely visible after two years.
Scoliosis surgery is a complex and major operation that is also associated with risks. The more severe the curvature, the more difficult the scoliosis operation is.
Potential complications include loosening of the implant or neurological deficits. In the experienced hands of a specialist in scoliosis surgery, complications from scoliosis surgery are rare.
One consequence of scoliosis surgery is the stiffening of parts of the spine. The fixed vertebral bones grow together and thus lose their function as a joint. This effect is intentional, but also means restrictions for the patient.
Depending on the length of the stiffening section, this loss of spinal mobility is greater or lesser. As a result, patients may be noticeably restricted in their everyday life and may not be able to take part in some sports.
In rare cases, some patients develop back pain as a late consequence, which requires further surgery.
Scoliosis surgery should be performed by experienced spinal surgeons. Finding the right clinic is not always easy. Subjective reviews on the Internet often give false impressions.
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