Scoliosis is a deformity in the spine that causes an abnormal C-shaped (one curve) or S-shaped curvature (two curves). Depending on the cause of the scoliosis, a variety of treatment plans are available including non-surgical options such as bracing or physical therapy. If the disease progressively worsens, surgical options may be necessary. ONE® Brain & Spine Center® in Irvine, Southern California is experienced in treating complex problems of pediatric and adult
A specific cause of scoliosis is unknown or idiopathic. Idiopathic scoliosis is the most common type and affects about two to three per cent of the population. It tends to run in families and is more common in girls than in boys. Most often it develops in middle or late childhood during a rapid growth spurt.
Scoliosis can also be congenital or it may develop as a result of another neurological condition such as cerebral palsy, split spine or “spina bifida,” or spinal muscular atrophy. Because the causes of adult lumbar degenerative scoliosis are broad, diagnosis by a spine surgeon expert in minimally invasive surgery (MIS) is important.
The most common symptom of scoliosis is the abnormal curve of the spine to the left or right and most often affects the thoracic and lumbar vertebrae. The change in the curve of the spine progresses slowly, making it easy to miss until it becomes severe. The vertebrae curve to one side and may rotate, which makes the waist, hips, or shoulders appear uneven. There are three types of scoliosis depending on when it develops.
Infantile scoliosis – Occurs from birth to three years of age.
Juvenile scoliosis – Develops between four and nine years of age.
Adolescent scoliosis – Presents from 10 years old and until growth is complete and the most common form of scoliosis.
Scoliosis curvature is usually in the upper back or mid back areas. Physical examination of the back is conducted to see if there’s a rib hump or asymmetry of the lumbar spine, or if the shoulders are different heights. If this is the case, follow-up clinical evaluation and an X-ray is the next step.
If the curve is small when first diagnosed, it can be observed and followed with routine clinical evaluation and X-rays. You may return to see you doctors at ONE® Brain & Spine Center® every three to four months to check for any worsening of the curve. Additional X-rays may be repeated each year to obtain new measurements and check for progression of the curve. If the curve stays below 25 degrees, no further treatment is required. If the curve is between 25-40 degrees and you are still growing, a brace may be recommended. If the curve is greater than 40 degrees, then a minimally invasive surgery may be recommended.
Traditional approaches involve making a long incision over the curve to be corrected and cutting and retracting the muscles and tissues over the spine to gain access to the vertebrae that need to be fused.
With advancements and innovations in endoscopic and minimally invasive surgical techniques, surgeons can achieve the same goals as open surgery, yet with much less trauma to the surrounding muscles and tissues through minimally invasive scoliosis surgery.
Minimally invasive scoliosis surgery is an endoscopic procedure in which surgery is performed through a few small incisions rather than one long incision. It achieves the same goals as traditional surgery, but with less trauma to the surrounding tissues and muscles. In endoscopic procedure, a thin instrument with an endoscope, a tiny video camera, is inserted through one of the small incisions. This provides the surgeon with internal images of the patient’s body projected on a screen in the operating room and guides the the surgeon in performing the surgery through the small incisions. The use of endoscope and fluoroscope improves visualization of the chest cavity and spinal column and allows greater flexibility for placement of the instrumentation in the spine.
Additional advantages of minimally invasive surgery include:
- Minimal to zero scarring
- Less blood loss during surgery
- Less post-operative pain
- Shorter hospital stay
- Reduced risk of infection
- Shorter recovery time
- Quicker return to work, daily chores or activities