Scoliosis is also known as curvature of the spine. It is characterised by curving of the spine, either to the left or the right, with accompanying rotation of the vertebrae. It is usually picked up in a standard check-up, when the physician notices a rib hump or a lumbar protuberance. Sometimes scoliosis surgery is called for. This is a specialist area at Friedrichshafen Clinic in Germany.
In 80% of cases, the cause of scoliosis is not found (idiopathic scoliosis). In can also be caused by neurological disorders, congenital deformities (hemi-vertebrae and block vertebrae), metabolic disturbances (Osteogenesis imperfecta) or tumours (neurofibromatosis, astrocytoma, syringomyelia).
Indications for scoliosis surgery in the thoracic spine lie at 50° curvature and in the lumbar spine at 40° curvature according to John Robert Cobb’s standard. However, this does not necessarily mean that scoliosis surgery is required. If the patient is free of pain and is not dissatisfied with his appearance, he is able to manage very well, even if the condition is relatively extreme. If the curvature is above 70°, it limits the patient generally and also has an adverse effect on the heart and the circulation. Scoliosis surgery is available at the Spine Centre at Friedrichshafen Clinic in Germany.
Scoliosis surgery is a life-changing procedure and should always be the last option. However, an unattractive rib hump or lumbar protuberance or very quick curving of the spine during an adolescent growth spurt are clear indications.
Before we perform scoliosis surgery at the Friedrichshafen Clinic in Germany, a detailed discussion takes place between the patient and the anaesthetist. This consultation, which usually takes place the day before the operation, is important and it is vital to allow sufficient time for it.
To begin with, the anaesthetist at our clinic in Germany asks the patient about his medical history, including diseases he has suffered from, whether he has ever had anaesthetic-related complications during surgery, etc. The next step is a thorough physical examination to ensure that the patient is fit enough for scoliosis surgery. ECG and lung X-rays will also be taken and then, taking all the results and diagnoses and the patient’s personal wishes into consideration, a decision is made as to the best way to proceed with the anaesthetic required before surgery. Patients at our clinic in Germany are thoroughly informed with regard to the advantages and disadvantages and also the risks and possible complications associated with the method that is chosen for their scoliosis surgery.
We at Friedrichshafen Clinic in Germany, strongly advise you to make full use of this consultation to ask all the questions that are important to you before making a decision about the spine surgery or spine treatment abroad. This will help to still any fears and doubts that you might have regarding scoliosis surgery. It is essential that you trust your anaesthetist so that you are calm when you enter our operating theatre in Friedrichshafen, Germany before surgery.
Once all your questions have been answered, you are required to sign a consent form in respect of the anaesthetic, before our surgeons at the Friedrichshafen Clinic in Germany can proceed with your scoliosis surgery. In the case of children, the parent or guardian is responsible for signing this form before our surgeons can proceed.
During the operation, the curvature of the spine is corrected and the spinal column is stabilised in its new position. For this purpose, certain vertebrae are fused to enable full weight-bearing in the future. Although this treatment reduces the mobility of the patient somewhat, it is usually described by the patient as being not severely limiting. The success of scoliosis surgery, followed by a rehabilitation period with appropriate physiotherapy, is generally good.
The outcome of scoliosis surgery is largely dependent on the cause of the curvature of the spine and from the specifics of the individual case. The degree of correction of the disorder depends on the degree of the curvature – about 50-60% in the case of 70° curvature. In an anterior approach to scoliosis surgery, a better degree of correction can be achieved, but not all curvatures are accessible with this approach, particularly in the thoracic vertebrae. In the case of thoracolumbar and lumbar curvature, the anterior and posterior approaches are equally effective for scoliosis surgery.
A decision must be made before scoliosis surgery, as to which approach is best. In the anterior approach, the vertebral processes and the vertebral arch are exposed to enable the implantation of the braces. To achieve the necessary degree of stiffening of the bone, after scoliosis surgery, bone chips from the pelvis are placed on the vertebrae after removal of the cartilage.
In the anterior approach to scoliosis surgery, which enables correction and fusion of the spine in a single operation, access is gained via the ribcage or the abdomen.
Because every case is different and scoliosis surgery is risky, it is vital to choose the right clinic. The spinal surgeon needs to have a great deal of experience and should have performed scoliosis surgery many times. Our spine surgeons at the Friedrichshafen Clinic in Germany have extensive experience in scoliosis surgery techniques.