Scoliosis fusion surgery is a procedure performed to correct the curvature of the spine resulting from disc degeneration of the spine (also) known as adult degenerative scoliosis. In many cases, the surgery can be performed using minimally invasive techniques. The disc degeneration may result in curvature of the spine, spinal stenosis and instability such as that seen with a spondylolisthesis. Symptoms typically include back pain, leg pain, numbness, tingling, and possibly weakness.
The function of surgical treatment is to dramatically improve quality of life. Back surgeon Dr. Sandro LaRocca could suggest surgical treatment in the event of notable weakness, soreness or when all other treatment methods have been exhausted.
What to Expect
Currently, there are three conventional techniques for performing a fusion operation: posterior (back) method, anterior (front) method and a blended anterior/posterior method. The suggested method relies upon the area and type of curve. No matter the method used, there is a quick return to function with bony recovery taking three to six months. A back brace could also be encouraged.
Posterior Surgical Approach
A posterior approach can be used to address any region of the spine: cervical, thoracic, or lumbar. From the back, Dr. LaRocca will surgically expose the bony structures of the spine. Screws are then inserted into the bone and rods are inserted to provide stability. Correction of the curve using these implants may also be obtained. When spinal stenosis is present, a laminectomy may also be performed.
After the rods are in place, graft material will be applied along the spine after the top layer of bone is removed to expose the soft healing bone underneath, promoting the fusion of the vertebrae. The bone graft material is rarely taken from the hip but may also be donated from a cadaver or consist of various biologically compatible materials that promote bone growth.
Anterior Surgical Approach
An anterior approach may be necessary if the realignment of the spine column and added stability is needed in any region of the spine It may provide added structural support and also increase the chance of fusion.
An anterior approach involves approaching the spine from the front of the body and performing an anterior release by removing the vertebral discs located between the affected vertebrae. When the appropriate discs are removed, the space will be filled with bone graft material to allow the vertebrae to fuse together.
After the discs between the affected vertebrae are removed to loosen up the spine, the empty disc space will then be filled with bone graft material or cages. These cages are typically packed with bone graft material to allow the vertebrae to fuse together. The bone graft material is rarely taken from the hip but may also be donated from a cadaver or consist of various biologically active materials that promote bone growth.
The Anterior Advantage
This approach has several advantages over the posterior approach including:
- Allows for better correction of spinal alignment
- Better fusion/healing rates
- Added structural support for the spine