Spinal Fusion and Instrumentation
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Scoliosis surgery in adolescents/adults typically involves spinal fusion, in which the vertebrae are fused with bone grafts and instrumentation. The instrumentation consists of metal rods that are attached to the spine to maintain curve correction. Most spinal fusions are performed through a posterior approach, in which the operation is performed with an incision in the back. The alternative is an anterior approach, which is done in some situations.
Why Is This Procedure Performed?
A spinal fusion and instrumentation is recommended in several situations, including adolescent scoliosis, where the curve has progressed to greater than 50 degrees. The underlying cause could be idiopathic, congenital, or neuromuscular. A spinal fusion and instrumentation are also recommended for patients with spondylolisthesis or spondylolysis who have failed conservative measures. A spinal fusion and instrumentation is also sometimes recommended in the young child with congenital scoliosis that is progressive. In that situation, the vertebra that is not formed correctly is removed (hemivertebrectomy), and a short spinal fusion and instrumentation is done.
Our Approach
Here at NewYork-Presbyterian/Morgan Stanley Children’s Hospital, we strive to make this surgery as safe as possible by minimizing the risks. As a major center for the treatment of children with spine issues, we have extensive experience treating all types of children with scoliosis. This experience has allowed us to develop protocols and checklists that help us deliver the safest and best experience to you and your child. In fact, we have led the development of best-practice guidelines in this area and are heavily involved in clinical research and national governance in pediatric spine care.
Recovery
Because of the stability and effectiveness of the devices used in these spine operations today, patients are usually able to walk the day following their surgery, and hospital stays are generally about 3-5 days. The majority of adolescents return to school within 4 weeks and can often return to full athletic activity within 6 months.