Operative

Operative Treatment for Scoliosis

In scoliosis patients with a significant curve of 50 degrees or more, spinal surgery is often the best treatment option. Surgery is also an option for scoliosis patients who did not achieve success with bracing. At Scottish Rite for Children, we offer multiple types of surgery to correct scoliosis including spinal fusions, as well as new and innovative methods like vertebral body tethering (VBT) and the magnetically controlled growing rods, also known as MAGEC® rods, for children that are still growing. Learn more about the different types of spinal surgery offered at Scottish Rite below.

RESOURCES FOR OUR PATIENTS

SPINAL FUSION

The most common surgery performed to treat scoliosis is called a spinal fusion. In a spinal fusion, the curved vertebrae are fused together to create a single, solid bone. This stops the growth in the abnormal part of the spine and prevents the curve from worsening. Metal rods attached by screws are used to hold the spine in place until the bone heals. In all spinal fusions, a bone graft is used to help promote the fusion and the bones grow together to create one solid bone.

Patients who have a spinal fusion will see an immediate improvement in the curve of their spine. This surgery also prevents the spine’s curve from progressing over time.
Most patients have a recovery period of about six weeks, during which some activities like bending or heavy lifting must be limited.
Following a spinal fusion, most patients can return to their normal activities after recovery, which usually is about four to six months.
In most cases, patients who undergo a spinal fusion do not require any additional surgeries.

VERTEBRAL BODY TETHERING

Vertebral body tethering (VBT) is a surgical treatment for idiopathic scoliosis in growing children. This surgery technique uses a strong, flexible cord that is attached to the spine with screws and anchors, and as a child grows, their spine will straighten over time. The cord encourages the spine to straighten as the patient grows. Vertebral body tethering is a growth modulation treatment that takes advantage of the spine’s natural growth. Growth modulation means modifying the normal growth patterns through tethering. The tether is placed along the curved side of the spine. This tether is used to slow down the growth of the curved side of the spine while the untethered side continues to grow. By using a tether, the spine can continue to bend and flex. It is not a fusion procedure, which is an advantage of pursuing this treatment.

VBT is an ideal treatment for children with idiopathic scoliosis who have curves of 30 to 65 degrees and who have significant bone growth remaining.
Unlike a spinal fusion, VBT allows for greater mobility and flexibility of the spine.
VBT surgery is less invasive than a spinal fusion and involves a shorter recovery time. In most cases, patients can return to most activities within three to four weeks after the surgery.
Unless a concern with the tether develops, the implants will not need to be removed once placed by the surgeon.

GROWING RODS

The MAGEC (MAGnetic Expansion Control) System ® is a growing device technique used for patients diagnosed with early-onset scoliosis (EOS) – children under the age of 10. In comparison to a spinal fusion, this is a less invasive, innovative treatment that reduces the number of surgeries a child must undergo. Once the surgery has been performed and the MAGEC rod is in place, the back must heal for about four to six months. Once the spine has healed, the patient will return to the clinic for his or her first lengthening session. During lengthening, the physician will use a magnetic wand to locate the magnets inside the MAGEC rod and make a mark on the back. Using an External Remote Control (ERC) device, the doctor will then lengthen the rod with a noninvasive adjustment. An X-ray or ultrasound of the spine is then used to confirm the procedure’s success.

The MAGEC rod is ideal for patients under the age of 10 who have a curve approaching 50 degrees and other forms of treatment (i.e. bracing, casting) have not been successful.
Children may need several lengthening sessions over time to achieve proper results.
During the ongoing lengthening sessions, children may remain active and continue all their favorite activities.
Lengthening sessions do not typically cause pain and additional surgeries are not usually required.

HALO-GRAVITY TRACTION

Halo-gravity traction is the process of gently stretching and straightening a significantly curved spine, as seen in patients with scoliosis and kyphosis. This method of treatment is usually the first step in a treatment plan before other treatments, such as bracing, casting or spinal surgery. While in halo traction, patients remain in the hospital for treatment, which can be several weeks to several months.

A surgeon will attach a metal ring or halo to your child’s skull. During the procedure, children are under general anesthesia and will not feel pain.
After the halo is placed, a traction device is attached using a pulley system that attaches to the child’s bed, wheelchair or walker. Over time, clinicians will add weight to the pulley to slowly stretch and straighten the child’s curved spine. During this process, clinicians will monitor your child’s movements and strength as well as take X-rays to track progress. Once your child’s curve has improved, the halo will be removed, and the next method of treatment will begin.
For a few days following the placement of the halo, your child may experience mild headaches that will be managed with pain medication. In many cases, children feel better once they have adjusted to the halo. The process of stretching and lengthening the spine often alleviates other discomforts and may improve breathing, appetite and standing.