Saturday, April 13, 2024

Surgery For Scoliosis In Adults

Adult Idiopathic Scoliosis Symptoms

Surgery for Adult Scoliosis – Mayo Clinic Health System

Most individuals with adult idiopathic scoliosis will experience pain in fact, it is typically discovered due to pain.

Potential signs and symptoms can include:

  • Low back pain or backache
  • Uneven hips and/or shoulders
  • One shoulder blade sticks out more than the other
  • Appearance of a hump on the back
  • Spine curves to one side
  • Pain and numbness that shoots down the legs

Data On Disc Release And Disc Health Long Term

00:29:59

Dr. Antonacci:

Thats going to be something separate. What we can say at this point is that it does not lead to a discogenic back pain problem. I dont see that. And what we notice on some of these staged surgeries or revisions is that theres good new healing of the disc that occurs. So a lot of it is anecdotal.

A good study that we need to do is were going to go ahead and get MRIs on a certain group of people that had their surgery done, and a year later look at the disc. Weve done that a few times. And the discs are OK, its not like theyre degenerating.

Cases: Asc For Extreme Curves

Extreme cases, 90 degree curves with ASC, you can actually again, this was a staged surgery that was done in two parts, but going from 90 degrees to seven degrees and getting this kind of control. And heres another, a different girl.

And the reason I brought this up is, again, this was a staged surgery, 90 degrees before about 13 or so degrees after. But you can see even in those severe cases and even with staged surgery, you can really get the motion with the cord.

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Why Does Scoliosis Develop In Adulthood

While scoliosis can sometimes be hereditary, or the result of a past trauma, the primary cause of adult deformity is aging, or natural wear-and-tear, as well as degenerative arthritis that occurs within the joints of the spine.

As a result of natural degeneration and arthritis, mild scoliosis is fairly common in advanced age. For some patients, however, deformity can progress and develop into spinal stenosis where nerves begin to get pinched, says Dr. Kang.

The primary symptom of scoliosis is pain in the legs caused by these pinched nerves, as well as low-back pain. Some scoliosis patients may not experience symptoms. To diagnose scoliosis, doctors use X-ray and MRI imaging.

The First 14 Days After Discharge

Request a Scoliosis Case Personal Review by Dr. Antonacci  Institute ...

During the first portion of the patients return home, he or she will need the help of a friend or family member to assist with daily living activities. Additionally, the patient will need a driver to assist with transportation, but should limit car rides whenever possible. The patient will be under the influence of strong medications and feel very weak. Therefore, rest is also extremely important during this phase.

There are also certain forms of movement that you should avoid. For one, you should try not to bend your back whenever possible. Doctors consider bending at the knees and hips to be viable alternatives when bending is necessary. Additionally, the patient should also avoid lifting anything above 8 pounds. This is where having an in-home helper can come in especially handy during the healing process. Lastly, the patient should avoid any motions that involve twisting the spine. This happens most naturally in the morning when the patient gets out of bed. Therefore, a conscious effort should be made to avoid injury during this time specifically.

Another important factor to consider during this period is incision site care. When the patient initially returns home, it is fine for him or her to take showers regularly under the condition that he or she covers the wound site while bathing. It is also important during this time to avoid using any creams or powders around the site of the incision to avoid irritation.

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Schedule Your Case Review

Our staff will answer any questions you may have about our approach, evaluate any x-rays or other images you may have and provide an initial assessment on whether we can help your child.

We can also put you in touch with other parents whose children have gone through our program if you want to talk to someone who has been there.

As always, this initial case review is done at no charge.

Two Weeks To Three Months After Discharge

At this point, some of the restrictions begin to lift during the recovery process. The incision wound from the surgery has healed to the point where the risk of infection is low enough to allow for the submersion of the surgical site in the water again. Additionally, your doctor will transition you off of narcotic medication and replace it with acetaminophen. This is really what opens up doors for the patient at this point during the process. Being off of these stronger pain medications will allow the patient to go out more with friends, albeit in a limited capacity.

At around six weeks, your doctor will take x-ray images of the spine to observe the development of fusion. During this time, you will still have low energy levels, but the spine will be healed to the point where even more restrictions may be lifted. For example, if things are going well, your doctor may allow you to drive again. However, most surgeons recommend that the patient undergo physical therapy beforehand. This will allow your PT to calculate pain levels, coordination, and reaction time prior to driving.

But of course, all of this depends on the individual. Everyone has different pain tolerances and idiosyncrasies that affect recovery. That being said, if you have a sedentary desk job or go to school, you may be able to return to those activities during this time depending on your progress.

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Staged Surgeries For 90+ Degree Curves

And we know that from our in this practice, we know that from our huge curves where Ive done 90, 100 degree curves. And what happens, I can get them from like braces, I cant get them from over here to here in one shot. If its a 90-100 degree curve, I need to correct them down to about 50 the first time.

Then I let them wait for five, six, nine months. Theyre getting flexible at 50 and 60. Then I go back and I revise that and bring it down to where we need to go.

Spine Conditions We Treat

What can I expect with scoliosis surgery?

Conditions treated at our hospitals include:

  • Abnormal curves: The curve in your spine may become too extreme. Your spine may also develop a twist or an extra curve. These conditions put pressure on the vertebrae and discs, causing pain. Abnormal curvatures include:
  • Degenerative disc disease: This refers to several types of spinal disc changes. The most common are discs thinning, hardening or drying out. This disease can also start or worsen because of injury, disease or stress.
  • Bulging discs: When the outer walls of spinal discs weaken, the discs may push out or bulge toward the nerves.
  • Herniated discs: The outer walls of spinal discs can tear or rupture. When this happens, the soft material inside the discs can squeeze out and press on nearby nerves.
  • Fractures: Vertebrae can crack or break. Fractures can happen because of an injury, repeated stress or certain medical conditions, such as osteoporosis.
  • Instability: Adjoining vertebrae can slip back and forth. They can also permanently shift out of position. A damaged disc, a bone injury or arthritis can cause instability. This condition may also be congenital . The slippage can irritate the bone, disc, spinal cord and nerves.
  • Spinal stenosis: Stenosis is a narrowing of the spinal canal.
  • Nerve problems: Many of the conditions described above can irritate the spinal cord or nerves. This can cause pain, numbness, weakness and other problems throughout your body.
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    Scoliosis Surgery For Children

    Sometimes bracing is not enough to stop a scoliosis curve from progressing. That could be because the brace wasn’t worn properlyfor example, it wasn’t worn tightly enough or for the right amount of time.

    However, in some cases, even a child who has been a good brace wearer and has followed the doctor’s recommendations exactly can have a curve that progresses. This is not the child’s fault. If the curve does keep progressing, your doctor may recommend spine

    surgery.

    The goal of spine surgery for scoliosis is to stop the curve from getting worse, restore the spine to a more normal alignment and appearance, and also to address any back pain or heart or lung function problems caused by the scoliosis.

    When Scoliosis Surgery May Be RecommendedChildren may be surgically treated for progressive scoliotic curves greater than 40°.

    How the Surgeon Plans the SurgeryTo prepare for and plan the scoliosis surgery, the surgeon will consider:

    • the number of curves

    • how severe the curve is

    • how old you are

    The surgeon may also order more x-rays or magentic resonance imaging scans to help him or her decide where and how to operate.

    Spine Surgery Procedures for ScoliosisFor scoliosis, spinal fusion using spinal instrumentation is the most common surgical procedure.

    The goal of the fusion is to stop movement between the vertebrae, providing long-term stability. The spinal instrumentation will help the spine stay straight while the fusion heals, which usually takes at least 6 to 9 months.

    Possible Complications Of Adult Scoliosis Surgery

    Like all surgical procedures, operations on the back may have complications. Because the surgeon operates around the spinal cord, back operations are always considered extremely delicate and may be dangerous. Finally, take time to review the risks involved with spine surgery with your doctor. Also, make sure you agree with both the risks and the benefits of the planned procedure.

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    Adolescent Scoliosis In Adults

    Adolescent Scoliosis in Adults is the adult version of scoliosis that presented during adolescence. Once skeletal maturity is reached , a patient with Adolescent Idiopathic Scoliosis is now said to have ASA. There is typically a slow increase in the curvature that began during teenage years in an otherwise healthy individual that becomes progressive during adult life. Where does that put you 10 years from now? 30 years from now?

    Here are characteristics of Adolescent Scoliosis in Adults :

    • Any curve type as long as it presented during adolescence
    • May be stable or progressive
    • May develop a degenerative stage later in life
    • Often not painful until later in adulthood
    • Pain typically an issue in unbalanced curves, especially curves in the lower rib cage area and those that are only in the lower spines
    • Often progressive later in life in a degenerative phase

    Despite extensive research, the only thing that we know about the future of the ASA patient is that we dont know. Pain becomes an issue for a majority of AIS sufferers, but there is no way of knowing exactly how your case of AIS will progress or deteriorate over time.

    Cases: Extreme Curves Revision Over

    Scoliosis and Kyphosis  Institute for Spine and Scoliosis

    And then, you know, how extreme can it get, this is a 90 degree same type of situation. And then I threw up some other curves for you to look at. But again, 85. This is 75 down in the waist. Another one. This is the VBT. This is not my case, but I did revise it.

    This is a VBT that didnt quite get the correction because you can only get it to 30, didnt grow out. And so then I went back and I revised it with the ASC technique. And same with this one, too, this is an overcorrected VBT, again, its hard to say, this is not VBT classically because they did do the lumbar portion as well.

    But without the principles of ASC that you can and Im not trying to say ASC is the perfect thing, but, you know, weve been through the process in this practice. And so this is the revision that I was able to achieve and can see the improvement with the double cords, double screws and how you can really get the proper contour. And heres another. This was another revision that I had to do for somebody.

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    Preparing For Scoliosis Surgery

    Spinal surgery can take a toll on your emotional & physical well-being. You should speak with your surgeon regarding any concerns you may have as this will help your surgeon to develop a better treatment plan with you to meet all your needs. Here are some things to think about:

    • Exercise Both pre- and post-surgery plan.
    • Diet Discuss your diet and nutritional needs and prepare a meal plan. Reheating food that is already cooked/prepared reduces stress and strain.
    • Personal Hygiene Your recovery period may last a few weeks, so prepare accordingly and stock up on the necessities, especially if you live alone.
    • Smoking Cessation Smoking can prevent your body from healing and your surgeon may require you to stop before surgery.
    • Recovery Environment Plan for a space that is close to the bathroom and has no stairs, a comfortable chair, allows for room for any equipment, and anything else that will help you to stay as comfortable as possible. Check with your surgeon to see what the hospital provides.
    • Pack for your hospital stay You will be admitted to the hospital and may stay several days. Please speak with your surgeon to determine how long and plan accordingly. We recommend leaving any valuables at home but having some reading material, travel sized toiletries, and loose-fitting clothes tend to be essential to reducing stress and improving your inpatient experience.

    Disability Related To Scoliosis In Adults

    Another terrible consequence of untreated scoliosis is disability. You lose your freedom to do the things that you love to do and can become less and less independent. Some severe scoliosis sufferers cannot even stand or walk because their condition is so degenerative. This is known as postural collapse and occurs in adults due to the relentless effect of gravity on the scoliotic spine.

    As scoliosis patients become older, the likelihood of disability increases. Without treatment, disability from scoliosis can cause you to be confined to bed, unable to move without the aid of someone else, and completely without freedom to do the things that you enjoy.

    One Strauss Scoliosis Correction patient had such severe scoliosis that she could not walk and was confined to her bed. She was without any freedom and independence. But after just 6 weeks, she was able to walk and move again without any pain or discomfort:

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    What Is The Outlook For Someone With Scoliosis After Surgery

    In most cases, you can see the effects of spinal fusion surgery immediately after surgery. The same is true for other surgical methods, although tethering devices can take additional time to produce the full effect.

    Despite the outward appearance that a curvature is fixed after spinal fusion surgery, it can actually take 1 to 2 years following surgery before the implants and bones of the spines completely fuse together.

    Spinal fusion surgery itself can take around 4 to 6 hours and requires a hospital stay of 3 to 4 days. Although complications are possible and healing takes time, people who have spinal fusion surgery generally have an improved quality of life after the procedure.

    What Are The Treatment Options For Adult Scoliosis

    Some Adults With Scoliosis Could Require Major Corrective Surgery

    There are two main treatment options for adults with scoliosis: Surgery and non-surgical interventions.

    Only a small percentage of patients with adult scoliosis will ever need surgery, but if surgery is deemed necessary its generally due to dysfunction related to back and leg pain, explains Dr. Kang. Patients who need surgery can benefit tremendously, but surgery is most likely not the best option for more than 90 percent of adults with scoliosis.

    For patients who are considering surgery, Dr. Chi and Dr. Kang always remind them that spinal surgery is a major event. These are invasive surgeries, so the decision can warrant a second or third opinion. Both spine specialists counsel patients and help them deeply consider the surgical option.

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    Asc Scoliosis Cases From Around The World

    This map shows a world-view of the hundreds of cases of ASC by Drs. ABC. All of the locations are general and do not include any personal information. Privacy is our main focus over accuracy. Locations may be in a generic spot, this includes public areas such as parks, business districts, or waterways.

    Reach Out For Help And Have A Productive First Visit

    • Reach out to us for a specialized spine care appointment today.
    • Gather all your past records for the visit. You may need to reach out to past providers or facilities for copies, so start early.
    • A Care Coordinator will ask you to fill out certain online Patient Forms and bring them to our office upon your first visit.
    • Write down some questions you may have to help you remember them during your visit.

    In the event of inclement weather:

    The Southwest Scoliosis clinic will follow the schedule of the school district in which the clinic is located.

    Please fill out the form below or call us at 214-556-0555 to schedule an appointment.

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    How To Manage Adult Scoliosis

    You may remember reporting to the nurse in middle school to be evaluated for scoliosis. If you were diagnosed with scoliosis in childhood, you likely wore a plastic brace as you grew. When most people hear of scoliosis they think of a younger teenager, but adults can develop scoliosis, too.

    Adult scoliosis isnt a new diagnosis, but its still growing in recognition. The treatment for adults is much different than the treatment for adolescents, says Brigham and Womens Hospital neurosurgeon John Chi, MD, MPH.

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