What is scoliosis?
Scoliosis is a common deformity of the spine that affects mostly in children and adolescents. Normally, spine should be straight line down the middle of the back. The spine with curve like letter “C” or “S” is scoliosis. Most of scoliosis is idiopathic scoliosis which means unknown cause. The goal of treatment is to prevent the curve from progressing to such a severe degree and correct the back,trunk and waist deformity.
Surgical treatment for scoliosis
The surgical procedure for scoliosis is instrumented spinal fusion. The general idea is to correct the spinal deformity with pedicle screw and rod, then fuse them together to make it heal in proper alignment. The precision of pedicle screw insertion is very important in scoliosis patient who has abnormal size and shape of the spine.
Combination of robotic-assisted spinal surgery and O-arm navigation will take advantages of both recent advanced technologies for scoliosis surgery including well planning of pedicle screw, precision of procedure and better visualization of anatomical structures can be achieved, thus increasing overall safety and providing better clinical outcome for patients.
How is it done?
Under general anesthesia with the patient lying on prone position, the patient will be monitor nerve function with intraoperative neuromonitoring. The surgeon makes a midline incision on back to expose the spine. The spine will be scan with O-arm navigator and images will transfer to robot computer. Planning for pedicle screws will be done with the software for the most accuracy of pedicle screw placement. Surgeon will perform surgery with the robotic guidance along with surgical planning and with real time navigation of O-arm navigator. After all pedicle screws are placed, the spine will be realigning into designed position. Spinal fusion will be done with bone graft. Surgery usually takes about 4 to 6 hours.
Indication for scoliosis surgery
Surgery for scoliosis may be recommended when:
- A curve continues to worsen and there is significant growth left in the spine.
- Brace treatment has failed.
- A curve of the thoracic spine greater than 45 -50 degrees.
- A curve of the lumbar spine greater than 35-40 degrees.
Risks and complications
As with any spinal surgery, the risks include:
- Bleeding occurring after surgery
- Infections could happen; however, it generally can be managed and cured effectively.
- Complication related to instruments, e.g. malpositioning and loosening
- Blood clot in the legs (deep vein thrombosis), which can dislodge and move to the lungs (pulmonary embolism)
- Nerve root damage
- Paralysis would be extremely rare with intraoperative neuromonitoring.
- Blindness is an uncommon complication
- Anesthetic complications
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