Surgical Procedures for Scoliosis

by Cynthia M. Johnson, MA

En Español (Spanish Version)

Surgery is often done on children with a curve over 40 to 50 degrees.

It is done to:

Stop the scoliosis from getting worse
Lessen the curve
Limit future health problems, such as lung disease due to a deformed chest cavity

Many surgery methods can be used. They are all done to:

Restore symmetry
Support the spine with or without:
- Steel rods, screws, or hooks
- Spinal fusion

The type of surgery done will depend on your child's age.

Fusion Surgery

Spinal fusion joins together adjacent vertebrae so they may grow into 1 solid bone. It will limit certain movements depending on how many bones are fused. Hardware is used to keep the spine in place while the bones fuse. This surgery is only done in children who are older than age 8 years. It is most often done in adolescents who are close to full growth.

Cotrel-Dubousset Procedure

This is 1 of the most common surgeries. It is a posterior spinal fusion. A metal rod is attached to each side of the spine using hooks attached to the vertebral bodies. The spine is then fused with a piece of bone from the hip area. The bone grows in between the vertebrae and holds them together and straight. The metal rods attached to the spine help the backbone stay straight while the fusion takes place. Part of a rod may need to be taken out if it causes later pain.

Thoracoscopic Anterior Instrumentation

Small incisions are made to insert a thoracoscope and surgical tools. There are some benefits to this surgery, but serious problems can happen. All options should be weighed before having this surgery.

Non-Fusion Surgery

Non-fusion surgeries help the curve correct itself over time. They do not restrict movement after the spine has healed. Some of these are new procedures and may not be done everywhere.

Epiphysiodesis—Stops growth on the left or right side of the spine. The other side of the spine will keep growing. There will be a slow correction.
Vertebral body stapling—Staples are used through a thoracoscope and inserted into the spine. The staple acts as a clamp to keep the spine stable. A rod may also be used to keep the spine stable while it heals.
Vertebral wedge osteotomy—A wedge-shaped part of the bone in the spine is cut out on the outside of the curve. The open space left in the spine is closed together. A temporary rod is inserted while the bones heal.
Magnetically controlled growing rods—A rod is implanted to straighten the spine. Growth adjustments to the rod are done with a magnet instead of through more surgeries.

REFERENCES:

Adolescent idiopathic scoliosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/adolescent-idiopathic-scoliosis. Updated June 1, 2019. Accessed July 24, 2019.

Congenital scoliosis and kyphosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/congenital-scoliosis-and-kyphosis. Updated January 19, 2016. Accessed July 24, 2019.

Idiopathic scoliosis in children and adolescents. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/idiopathic-scoliosis-in-children-and-adolescents. Updated March 2015. Accessed July 24, 2019.

Infantile and juvenile idiopathic scoliosis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/infantile-and-juvenile-idiopathic-scoliosis. Updated March 5, 2018. Accessed July 24, 2019.

Scoliosis in children and adolescents. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/health-topics/scoliosis. Updated December 30, 2015. Accessed July 24, 2019.

Last reviewed June 2019 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD
Last Updated: 10/18/2019

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