Scoliosis Surgery

Scoliosis surgery in India is a great attraction for medical tourists because of excellent facilities and low costs of services. Scoliosis treatment in India is a good solution for scoliosis patients due to:

• High quality medical care
• Qualified, skilled and competent spine surgeons
• Cost effectiveness and better communication due to no language barrier
• Low cost of scoliosis surgery in India

Overview
Scoliosis is the lateral curvature in a normal straight spine mostly occurring during the child’s growing years. A side view shows convexity in upper back and concavity in lower back though it looks normal from front or back view. It can be seen in 3 shapes:

• single curve on left/ C shaped/ levo-scoliosis
• single curve on right/dextro-scoliosis
• two curves/ S shaped

CAUSES
There can be many reasons for scoliosis, which can be categorised into:
Congenital: Congenital scoliosis is the scoliosis present by birth due to embryonic malformation of one or more vertebrae and can occur at any location of the spine. Since scoliosis is present by birth, it is diagnosed early in life.
Neuromuscular: Neuromuscular scoliosis is because of any neurological or muscular disease like cerebral palsy, muscular dystrophy or spina bifida. Neuromuscular scoliosis generally progresses very rapidly and needs surgery.
Idiopathic: When the exact cause of scoliosis is not known, it is ascribed as idiopathic. It accounts for 80% of all known cases of scoliosis and is usually detected during puberty.
Most cases of scoliosis are mild and do not require any surgery. However, some children develop deformities that continue to get severe as they grow, which can be disabling. Severe spinal curve can reduce the amount of space within the chest making lung functioning difficult.

Treatment options:
The aim of the scoliosis surgery in India or scoliosis treatment in India is threefold:

1. Safely straighten the spine as much as possible
2. Balance the torso and pelvic areas
3. Maintain the correction for long term

This is done by two methods

1. Spinal Fusion – fusing the vertebrae along the curve
2. Supporting the spine – with rods and screws till the fusion takes place

Once the bone fuses, the spine does not move and the curve does not progress.
The surgery is done by two approaches:

Posterior (done through back) or Anterior (through sides) approach. Both have their own merits and demerits.
The surgery for treatment of scoliosis in India is done under general anaesthesia and can take anywhere between 4-12 hours depending on the curve and how much spine needs to be fused. Hospital stay of about a week is required after the surgery to make sure you are on the right healing path.

Candidates
Candidates for scoliosis surgery are adolescents if their curves are greater than 40 degrees and it continues to progress and adults with curves greater than 50 degrees. A good candidate for scoliosis spine surgery is one who is otherwise healthy, mentally and emotionally stable and can tolerate the surgery well.

Procedure
1. Posterior Approach

• A long incision is given on whole length of thoracic spine
• The muscles are separated from spine which gives access to the spine
• Rods are inserted to reduce the curve and screws are used to hold them
• Bone is inserted which causes spine fusion. Fusion progresses for 3 to 6 months but can

Severe deformation and rigid curvature requires other prior procedure called anterior release of disc space, after which bone is added to aid in fusion.

2. Anterior Approach for scoliosis
Curves present at thoracolumbar junction (T12-L1) can be treated by anterior approach.

• This requires open incision and rib removal. The diaphragm is released from chest wall and the spine, so proper access is presented to the spine.
• Disc is removed so that the spine is loosened.
• Rods are introduced to reduce curvature and screws are used to keep it in place.
• Disc space is introduced with bone for fusion. Fusion proceeds for 3 to 6 months, and continues for 12 months.

Advantages of anterior approach are:

• Number of vertebrae fused is less and allows additional segment motion is allowed.
• The stress overload on few segments is prevented.
• Better aesthetic appearance is achieved with better curve reduction

Expected Results Scoliosis surgery is quite successful in stopping the curve from growing. With sophisticated techniques, doctors can straighten the curve to a great extent which improves the patient’s appearance and functioning to a great extent.

Recovery
You would have a lot of pain after the surgery which would be controlled with pain medications. You would stay at the hospital for about a week to ten days to make sure you are on the right healing path. The surgeon would advise you to start walking on second or third day of the surgery and physical therapy would begin on the third or fourth day of the surgery.
Most people return to school and work in 3-4 weeks. Full recovery can take from 4-6 months and most people can resume other activities and even sports after an advice from the surgeon.

Time and Cost
You would need about a week to ten days at the hospital and another two weeks for initial recovery after scoliosis surgery in India.