Scoliosis Surgery in Tunisia
Definition of Scoliosis
Most scoliosis surgeons agree that children who have very severe curves (45-50° and more) will need surgery to reduce the curve and prevent it from getting worse. Scoliosis surgery is a spinal fusion. The basic idea is to realign and fuse the curved vertebrae so that they heal into a single solid bone. With the tools and technology available today, scoliosis surgeons are able to significantly improve curves.
Do I Need Surgery?
If your curve is greater than 45-50°, it will most likely worsen, even after you have finished growing. This can increase the cosmetic deformity of your back and affect your lung function. Surgery is recommended. Curves between 40° and 50° in a growing child fall into a gray area - several factors can influence whether surgery is recommended. These should be discussed with your surgeon.
How Successful is Scoliosis Surgery?
Spinal fusion is very successful at stopping the growth of the curve. Today, doctors are also able to straighten the curve significantly, which improves the patient's appearance.
How Straight Will My Spine Be After Surgery?
Because your spinal bones protect your spinal cord, your surgeon will only straighten the bones to the extent that it is safe. The degree of correction from surgery depends on how flexible your scoliosis is before your operation. In general, the more flexible your curve is, the better the correction from surgery. Your doctor can measure your flexibility before surgery with special X-rays called bending or traction films. Most patients recover from surgery with curves straightened to less than 25°. In many cases, these small curves are barely noticeable.
What Does Spinal Fusion Surgery Involve?
In a spinal fusion, the curved vertebrae are fused so that they heal into a single solid bone. This will completely stop growth in the abnormal segment of the spine and prevent the curve from worsening. All spinal fusions use some type of bone material, called bone graft, to promote fusion. Generally, small pieces of bone are placed in the spaces between the vertebrae to be fused. The bone grows together - similar to how a broken bone heals. Metal rods are typically used to hold the spine in place until fusion occurs. The rods are attached to the spine by screws, hooks, and/or wires. The exact amount of spine fused depends on your curves.
What is a Bone Graft?
A bone graft is primarily used to stimulate bone healing. It increases bone production and helps the vertebrae heal together into a solid bone. In the past, a bone graft taken from the patient's hip was the only option for fusing vertebrae. This type of graft is called an autograft. Harvesting a bone graft may require an additional incision during the operation. It increases the length of surgery and may cause increased pain after the operation due to an additional pelvic area being involved in the procedure. An alternative to harvesting a bone graft is an allograft, which is cadaver bone. An allograft is typically acquired through a bone bank. Nowadays, several artificial bone graft materials have also been developed.
How Long Does the Surgery Last?
Most fusions last from 4 to 8 hours, depending on the size of the patient's curve and the amount of spine to be fused.
What Pain Will I Feel After Surgery?
The amount of pain reported by people after surgery varies greatly from patient to patient. Surgery is a major procedure that involves moving muscles and realigning the skeleton. The first few days are usually quite uncomfortable, but most people improve quickly by the third or fourth day, and they can walk around and get up and about well enough to go home. Pain continues to improve gradually, and most teenagers can return to school 2 to 4 weeks after surgery. Some mild pain may persist, but 3 to 6 weeks after surgery, pain medication should no longer be needed.
Do the Rods and Other Implants Stay in My Spine Even After Fusion?
If rods are used in a fusion, they generally do not need to be removed. Very few people need to have the rod removed, which may be due to various reasons such as infection or a broken rod.
Will the Fusion Make My Back Stiff and Unable to Move?
The fused part of your back will be permanently stiff. Most people have enough movement in the non-fused part of their back to perform all activities of daily living and most sports. If you participate in activities that require great flexibility, it may take some time to adapt. Most people find that within about a year, their back begins to feel "normal" when participating in these activities.
Can My Scoliosis Be Corrected Without Fusion?
We wish we had a method and materials that would straighten the spine and also allow normal movement between all the bones. Unfortunately, we do not have this capability. Anything we put in to hold the spine straight also makes the spine rigid in that area of surgery.