Scoliosis is the abnormal curvature of spine giving the spine a “S” or “C” shape. Scoliosis can occur at any age and is more common in girls than boys. Larger curves cause discomfort while the smaller curves do not cause any problems. In most cases, the exact cause remains unknown.
Based on type of scoliosis, age of the patient, and severity of curvature, surgeons will recommend either non-surgical or surgical treatment. Non-surgical treatment includes periodical observation at 4 to 6 months intervals and bracing depending on the age of the patient. If the curve is mild and patient has balanced patterns of malformation, it requires no treatment. Doctor will observe these changes by X-rays taken during the period of rapid growth.
Surgical options include:
- Spinal fusion - It involves fusing the vertebrae involved in the abnormal curve with the help of bone grafts and internal fixators such as metal rods, wires, hooks, or screws. These internal fixators help to stabilize the fusion and partially help to straighten the spine.
- Hemivertebra removal – In this procedure, the hemi vertebrae or abnormally shaped vertebrae are removed and the vertebrae present above and below the hemi vertebrae are fused together with the help of metal screws and rods. This procedure helps to straighten the spine and allows the adjacent portion of the spine to grow normally.
- Growth rod insertion – Spinal fusion surgery may cause impairment of the chest and growth of the lungs in a very young child. Therefore, before a definitive fusion surgery, doctors recommend a procedure involving insertion of growth rods. Two rods will be attached to the spine above and below the curve allowing the spine to grow while correcting the curvature. These rods will be left in place until the child is completely grown after which spinal fusion surgery will be performed.
- Reconstructive osteotomy and instrumentation – This procedure is done if spine deformity in children causes breathing problems, pain and risk to the spinal cord or impairment of the torso shape. In such cases osteotomy is done to remove part of the vertebral column and then followed by insertion of internal fixators such as metal rods, hooks, screws and wires to restore the balance of the spine.