FAQ, Part 2

What is the surgery?

During surgery, the curve is corrected as much as is safely possible. To do that, implants (generally rods, screws, wires and/or hooks) are attached to the vertebrae at the section of the spine that is curved. After correction is achieved, bone graft is placed over the implants. With time, this bone graft fuses (or grows together) with the existing bone and forms a solid column of bone in that area.

The implants act as an internal brace to hold the spine in the corrected position while the bones are fusing. This generally takes 6-12 months. The fusion of the bones takes away the growth potential in that part of the spine, which is what has caused the scoliosis to worsen. Individual vertebrae grow approximately 1mm per year and potential height lost is generally balanced by the amount of height gained with correction of the curve(s).

What are the effects of bone fusion?

Bone grafting is used to fuse the spine in its corrected position and it will likely be bone removed from the spine during the surgery. The fused section of the spine is no longer flexible. This is of little consequence in the thoracic spine because this region of the spine has relatively little natural motion. However, the lumbar spine is more flexible, and a fusion in this area would limit some motion, so every effort is made to fuse as few of the lumbar vertebrae as possible.

Why now?
Shouldn’t we wait until Daryl is done growing, or wait until it is causing symptoms?

With moderate scoliosis, we wouldn’t expect him to be having any health problems. Surgery is often recommended before pain and other symptoms develop for a variety of reasons. The ease of addressing the smaller, more flexible curves present in a child or teen versus the larger, rigid curves in adults involves less risk, a less complicated surgery and the potential that fewer vertebrae may need to be fused. In addition, the recovery is easier and life is less complicated (in terms of school, family, career) during adolescence.

Ref: http://www.settingscoliosisstraight.org/HSG_Scoliosis_Handbook858.pdf