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Dr. Paresh Bang
Consultant Spine Surgeon
Surgery for deformity spine In Chandrapur
Surgery for deformity spine
Spine deformity surgery deals with the condition of abnormal curvatures or malformations in the spine, such as scoliosis, kyphosis, or lordosis, and some situations in the spine, including spondylolisthesis. It would be characterized by significant pain and mobility constraints or compression of nerves and organs. The surgical approach is indicated in cases where nonsurgical interventions, such as bracing, physical
SCOLIOSIS AND KYPHOTIC DEFORMITIES
Neurological Surgery physicians at the University of Florida treat patients with scoliosis and kyphotic deformities.
A rib hump, pelvic or shoulder height imbalance tend to common in the adolescent group. Intractable back pain, sciatica, leg weakness or numbness and gait difficulty are common reasons for surgical correction in adults.
Infantile Scoliosis occurs in children less than 3 years of age and is most commonly associated with other serious congenital or neurodegenerative disorders like cerebral palsy, tethered spinal cord, and myelomeningoceles, among others. Surgery is sometimes necessary, but often non-operative techniques are used to allow for spinal growth prior to a spinal fusion procedure.
Kyphosis
Kyphosis is seen when a person’s spinal balance has moved too far forward to allow the spine to effectively carry the body weight without progressive deformity, pain or neurologic loss of function. Patients typically walk in a forward flexed posture being unable to stand up straight. This condition can also occur along with scoliosis causing Kyphoscoliosis.
Treatment Options
Treatment recommendations are made based on a combination of the severity of the curvature of the spine, the impact on the patient’s ability to function on a day-to-day basis, their age and other medical conditions. In very selected cases in younger, cosmetic appearance is a reason for surgery. In general, the treatment should match the magnitude and risks of the symptoms.
Bracing
In more mild forms of spinal deformities, bracing may be an option for younger patients where the spine may be .encouraged. to grow straighter. Adults may get some relief of pain with a brace, but it will not correct the deformity. Bracing may cause some problems like skin irritation or muscle disuse.
Physical Therapy
A mainstay of treatment is the flexibility and core strengthening of the spine, which can be enhanced by Physiotherapy (PT). There are many acceptable forms of PT, but they all share an active component where the patient exercises and strengthens the spinal musculature, improves range of motion and balance. It should be an active process, not simply limited to passive modalities like heat, ice or massage.
Pain Management Injections
The injection of cortisone and similar medications with can offer temporary of focal relief of pain from mild nerve compression or joint arthritis. The injections are frequently repeated in groups of three and can only be given safely once or twice per year because of the side effects of the medications.
Surgical Correction
Prior to considering surgery, the typical patient should have tried and failed to manage their symptoms with non-operative treatments. Surgery should be considered in patients whose pain in medically refractory, or have neurologic symptoms including weakness, numbness or bowel or bladder dysfunction. Progressive worsening of the curvature is a common reason for surgery, and is the reason that patients are followed with yearly x-rays.
- Scoliosis: A sideways curvature of the spine, often shaped like an “S” or “C.”
- Kyphosis: An excessive outward curvature of the spine, causing a hunched or rounded back.
- Spondylolisthesis: A condition where one vertebra slips over another, often resulting in back pain and nerve compression.
- Lordosis (Hyperlordosis): An excessive inward curvature of the lower back.
- Congenital Spinal Deformities: Present at birth, these conditions result from improperly formed vertebrae.
Types of Spine Deformity Surgeries:
Spinal Fusion
- Purpose: Fuses two or more vertebrae together to stabilize the spine, correct the deformity, and prevent further progression.
- Procedure: Bone grafts or metal rods, screws, and plates are used to hold the vertebrae in place while they heal into a single unit.
- Indication: Commonly used for scoliosis, kyphosis, and spondylolisthesis.
Osteotomy:
- Purpose: Involves removing or cutting parts of the bone to correct severe deformities and allow for better spinal alignment.
- Procedure: The bone is reshaped, and internal fixation devices are used to maintain alignment.
- Indication: Used for more severe cases of scoliosis, kyphosis, or other complex deformities.
Vertebral Body Tethering (VBT):
- Purpose: A less invasive option that uses flexible cords to correct scoliosis without rigid fusion.
- Procedure: A flexible cord (tether) is attached to the vertebrae on one side of the spine to gradually correct the curve as the patient grows.
- Indication: Often used in younger patients whose spines are still growing.
Posterior Spinal Instrumentation and Fusion (PSIF):
- Purpose: Metal rods, screws, and hooks are attached to the back of the spine to correct deformity and hold it in place.
- Procedure: Fusion of the spine in the corrected position occurs over time.
- Indication: Used for severe scoliosis or kyphosis.
Growing Rod Surgery:
- Purpose: Used for children with early-onset scoliosis, this technique helps correct spinal curvature while allowing the spine to grow.
- Procedure: Adjustable rods are implanted along the spine and lengthened as the child grows.
- Indication: Suitable for young children with progressive spinal deformities.
Spinal Decompression:
- Purpose: Relieves pressure on the spinal cord and nerves caused by deformities.
- Procedure: Removal of part of a vertebra (lamina) or disc to create space for the nerves.
- Indication: Can be combined with other procedures, especially when deformities compress nerves, causing pain or neurological symptoms.
Recovery:
- Hospital Stay: Most patients stay in the hospital for several days post-surgery, depending on the complexity of the procedure.
- Rehabilitation: Physical therapy is often required to strengthen the muscles around the spine and improve flexibility. It is an essential part of recovery, especially after fusion surgeries.
- Recovery Time: Recovery can range from a few months to a year, depending on the procedure and the patient’s overall health. Children often recover more quickly than adults.
- Follow-Up: Regular follow-ups with the surgeon are essential to monitor the healing process and ensure the spine is fusing correctly or that rods/tethers are functioning as intended.Contact Us
Risks of Spine Deformity Surgery:
- Infection: As with any surgery, infection is a possible risk.
- Nerve Damage: Spinal surgeries carry a risk of nerve damage, which could lead to weakness or loss of sensation in the limbs.
- Hardware Failure: In some cases, the rods, screws, or other hardware used to stabilize the spine may shift or break.
- Non-Union: In spinal fusion surgery, the bones may fail to fuse properly, requiring further surgery.
- Reduced Flexibility: Spinal fusion may limit flexibility in the treated area, though this is typically compensated by improved overall function and posture.Visit Our Hospital