What is scoliosis?
Scoliosis describes a malposition of the spine. The spine deviates from the longitudinal axis, and the vertebral bodies are twisted and displaced relative to each other. The shape of the vertebral bodies can also deviate from the physiological form. 90% of scoliosis is idiopathic, meaning the cause is still unknown. This form occurs mainly in girls during puberty. The remaining 10% are called secondary scoliosis and are caused by other diseases.
How is the curvature of the spine determined?
Even a physical examination can provide information about this malposition. During the prophylaxis test, the position of the spine can be examined, and the position of the vertebral bodies can be determined. For more clarification and documentation, an X-ray of the entire spine is taken while standing. Bone structures can be detected particularly well in the X-ray image. The location of the deformation and the deviation from the norm can be measured in the image. Based on the angles of curvature, scoliosis can be classified into degrees of severity.
Scoliosis treatment: When is scoliosis surgery appropriate?
The degree of severity can determine whether scoliosis surgery is appropriate. If the angle of curvature is greater than 50 degrees, surgery must be performed. Surgery is also recommended for children and adolescents with scoliosis who have a disease progression or are at risk of progression.
Surgery for scoliosis in children
At the beginning of therapy for children, rehabilitation measures and conservative therapy should always be considered, such as wearing an individual corset. Since, otherwise, scoliosis will quickly worsen due to the child’s growth, the measures taken before treatment should be systematically followed. Children should be operated on if one of the following criteria applies:
- Curvatures of the thoracic spine from 50
- Double scoliosis, or S-shaped, from 40 to 50
- Curvature of the lumbar spine from 35
Scoliosis surgery in adults
If untreated or if not treated sufficiently, scoliosis can progress further and have serious consequences. Osteoarthritis and severe pain can occur in adulthood. In many cases, scoliosis surgery is also helpful in adulthood. Mainly, surgical intervention is urgently indicated when medications and conservative methods can no longer control the pain. Surgery can be considered even if the osteoarthritis of the affected sections of the spine is too advanced or if the deformity is considered an aesthetic disfigurement.
Surgical procedure and duration of scoliosis surgery
The operation’s objective is to restore the spine to its normal shape and stabilize it. The procedure known as spondylodesis is used for this purpose. In this procedure, the vertebral bodies are connected to each other by screws, rods, and plates. These implants allow the vertebral bodies to grow together. The implants could theoretically be removed after the fusion, but performing another operation is not very useful. The surgery is carried out under general anesthesia, either through the abdomen or through the back. The chosen procedure will be decided individually for each patient.
Risks and follow-up
As with any surgery, there are risks. These include wound healing disorders, infections, bleeding, or nerve damage. General anesthesia can also cause problems during and after the operation. In most cases, patients are provided with a corset after the surgery to stabilize the spine. The duration of wearing the corset and the time when physical exertion can be resumed depend, among other things, on the age, the disease, and the extent of the surgery. At regular intervals, it is necessary to check the surgery results and the success of additional conservative measures.
How much does a scoliosis operation cost?
Statutory and private health insurance companies cover scoliosis surgery costs if it is medically necessary. The costs amount to 10,000-15,000 euros, depending on the scale of the operation and the duration of the subsequent stay in the hospital.
Which doctors and hospitals specialize in scoliosis surgery?
In orthopedic and trauma surgery clinics or practices, patients and parents of affected children can learn about their methods of treating scoliosis. Specialists trained in spinal surgery operate orthopedics and trauma surgery.