Scoliosis and Role of Osteotomies in Treatment

Although scoliosis is frequently thought of as a straightforward curvature of the spine, it is actually a complicated three-dimensional abnormalities that can significantly impact a person’s posture, mobility, and general quality of life. Knowing the basics of scoliosis and the surgical methods used to treat it can help patients and their family navigate the problem and feel more confident about their treatment.

Scoliosis: What is it?

An abnormal lateral curvature of the spine over 10 degrees is called scoliosis, and it is typically accompanied by sagittal imbalance and vertebral rotation. Although people of all ages can be affected, adolescence—a time of fast skeletal growth—is when it is most frequently diagnosed.

There are various forms of scoliosis, including:

The most frequent type of scoliosis is idiopathic scoliosis, which has no known cause.
Congenital Scoliosis: This condition is brought on by congenital defects in the spine.
Neuromuscular Scoliosis: Linked to muscular or neurological conditions (e.g., muscular dystrophy, cerebral palsy).
Due to spinal damage, older persons frequently develop degenerative scoliosis.

Why Is Correction Necessary for Scoliosis?

Progressive scoliosis can result in the following, albeit some curves are moderate and merely need to be observed:

Chronic back pain
Cosmetic abnormality
Impaired heart or lung function (in extreme situations)
An overall decrease in life quality

Preventing long-term consequences requires early detection and effective management.

When and Why to Have Surgery

Surgery may be considered if conservative measures, such as bracing or physical therapy, are ineffective or if the spinal curvature is severe (usually greater than 40 to 50 degrees). The main objectives of surgery are:

Fixing the spinal abnormality
Progress of the halting curve
Re-establishing the alignment and balance of the spine

Why Are Osteotomies Important in Scoliosis Surgery? What Are They?

A surgical procedure called an osteotomy involves cutting a bone to provide room for realignment. Osteotomies are essential in scoliosis surgery, particularly for individuals with severe or inflexible abnormalities.

Different Osteotomy Types for Scoliosis:

Osteotomy Smith-Petersen (SPO):

Involves cutting off the ligaments and facets at the back to make room for extension at a certain level of the spine.
Ideal for curves that are flexible and have mild to severe kyphosis.

Osteotomy of the Ponte:

Like SPO, but usually applied to the thoracic spine.
Frequently used for curve repair using posterior-only techniques in adolescents with idiopathic scoliosis.

Osteotomy via Pedicle Subtraction (PSO):

A more drastic method in which a wedge-shaped portion of the vertebral body is removed.
Recommended for kyphotic abnormalities that are angular and stiff.

VCR, or vertebral column resection:

A complete vertebra is removed in this extremely complicated procedure.
Saved for severe, inflexible, or unsuccessful deformity repairs.

The severity, location, and rigidity of the scoliosis determine the precise indications for each osteotomy. The choice is tailored to the anatomy, surgical objectives, and patient’s condition.

Results of Surgery and the Recovery Process

Despite being a technically challenging treatment, osteotomy-based scoliosis repair can result in notable enhancements in spine alignment, pain reduction, and functional mobility. Enhancing balance, speeding up healing, and strengthening spinal support are all made possible by postoperative therapy.

Usually, patients are counselled on:

Postural training and physical therapy
Frequent imaging follow-up
Changes in lifestyle for long-term spinal health

Concluding

More than just a spinal curvature, scoliosis is a disorder that can affect a person’s physical and mental health. In order to provide patients with the finest results, our neurosurgery centre combines cutting-edge surgical methods, such as osteotomies, with compassionate care. Know that there is support available if you or a loved one has scoliosis, and that with the correct direction and assistance, recovery is achievable.

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