Scoliosis

As we move through our daily lives, the thought of our spinal alignment might not often cross our minds. Yet, for those grappling with scoliosis, the curvature of the spine becomes a constant concern. Scoliosis isn't just a misalignment; it can affect one's quality of life, from physical discomfort to emotional strain. However, there is hope in the hands of experts like Dr. Rajat Mahajan, renowned as the best spine surgeon in Delhi, who specializes in providing relief and restoring alignment for those with scoliosis.

What Does Scoliosis Mean?

Scoliosis is a medical condition characterized by an abnormal sideways curvature of the spine. Instead of the spine appearing straight when viewed from the front or back, it forms an "S" or "C" shape. This curvature can range from mild to severe and often develops during the growth spurt just before puberty. While the exact cause of most cases of scoliosis is unknown, it can sometimes be linked to conditions like cerebral palsy, muscular dystrophy, or congenital disabilities.

One of the challenges of scoliosis is that it can progress slowly, and its symptoms might not be immediately noticeable. Some common signs include:

• Uneven shoulders or waist
• One shoulder blade that appears more prominent than the other
• Leaning to one side
• Back pain, although not always present
• Visible curvature of the spine

When Surgery is Considered

One of the primary considerations for scoliosis surgery is the severity of the curvature. Mild cases of scoliosis, where the curvature is less than 25 degrees, often do not require surgery. If the curvature continues to worsen, especially during growth spurts in adolescence, surgery may become a consideration. For adolescents with idiopathic scoliosis, surgery is often considered when the curvature reaches 40 to 50 degrees or more. This is because the spine is still growing, and without intervention, the curve is likely to progress.

Scoliosis surgery is typically considered when the curvature of the spine is severe and progressive, causing significant pain, discomfort, or impairing daily functions. It's also an option for those whose curves continue to worsen despite other treatments like bracing or physical therapy. The decision to undergo surgery is not taken lightly and is always a collaborative effort between the patient, their family, and an experienced spine surgeon like Dr. Rajat Mahajan.

Types of Scoliosis Surgery

There are several surgical approaches to treating scoliosis, and the choice depends on various factors, including the severity and location of the curvature, the patient's age, and overall health. Here are some common surgical procedures:

• Spinal Fusion: Spinal fusion is one of the most common surgical treatments for scoliosis. During this procedure, our surgeon joins two or more vertebrae together using bone grafts or implants. This "fuses" them into a single, solid bone. The goal is to straighten the spine and prevent further curvature.
• Growing Rods: This technique is often used for children with scoliosis who are still growing. Adjustable rods are attached to the spine and periodically lengthened as the child grows. This allows for controlled correction of the curvature over time.
• Vertebral Body Tethering (VBT): VBT is a newer, less invasive procedure suitable for certain types of scoliosis. It involves attaching a cord to the vertebrae to gradually correct the curvature as the child grows. Unlike fusion, VBT allows for some spinal flexibility.
• Minimally Invasive Surgery: Dr. Rajat Mahajan is known for his expertise in minimally invasive spine surgery. This approach involves smaller incisions, reduced muscle damage, and quicker recovery times. While not suitable for all cases, minimally invasive techniques can be highly effective for certain types of scoliosis.

Like any surgical procedure, scoliosis surgery comes with inherent risks. These can include:

• Infection at the surgical site
• Blood loss during surgery
• Adverse reactions to anesthesia
• Blood clots
• Instrumentation failure (for example, rods or screws used in the surgery)

While these risks are present, they are typically minimized through careful planning, advanced surgical techniques, and post-operative care. One of the most concerning risks associated with scoliosis surgery is the potential for a neurological deficit. This refers to any impairment of the nervous system, such as weakness, numbness, or loss of sensation. But, the chance of a neurological deficit in scoliosis surgery is incredibly low, at just 0.1% (1 in 1000).

Duration of Hospital Stay

The typical hospital stay for scoliosis surgery is around 7 days. Before the surgery, a child will be admitted a day in advance. Our surgeon will provide a detailed briefing about the procedure during this time. Additionally, some pre-anesthetic workup will be done to ensure everything is in place for a successful surgery. It's important to note that blood transfusions are usually not required for this type of surgery.

Implants for Deformity Correction

One common question patients have is whether they will require implants for the surgery. In scoliosis surgery, implants in the form of screws and rods are indeed necessary for deformity correction. These implants help to straighten and stabilize the spine, allowing for better alignment and posture.

Improvement in Appearance

After surgery, patients often notice a significant improvement in their appearance. The hump over the back should decrease significantly, if not disappear altogether. Shoulder imbalances may also become better post-surgery. Many patients express great satisfaction with the cosmetic results after undergoing scoliosis surgery with Dr. Rajat Mahajan.

Return to Sports and Activities

A common concern for active individuals is whether they will be able to return to sports after surgery. The good news is that almost all patients can resume sports activities around 6 months after surgery. However, it's worth noting that gymnastics may present some challenges in returning to full activity levels.

Range of Motion and Flexibility

Patients often wonder if surgery will affect the range of motion and flexibility of their spine. The part of the spine that is fused during scoliosis surgery will lose mobility. However, only a portion of the spine is fused, allowing for normal motion in the rest of the spine. Most patients do not notice a significant change in their range of motion after surgery.

Growth Sparing Surgeries: Exploring Options for Young Patients

For young patients, especially those under 10 years of age, growth-sparing surgeries may be necessary. These surgeries aim to correct the curvature while allowing for continued growth and development. Two standard techniques are:

• Growing Rods: These are used in children to allow for continued growth while gradually straightening the spine. Multiple distractions are required, and children typically return for regular appointments every 3 to 6 months for adjustments.
• VEPTR (Vertical Expandable Prosthetic Titanium Rib): This is used in children with scoliosis and multiple rib anomalies. It helps to correct the curvature while supporting proper chest development.

Advancements in Treatment: Magnetic Controlled Growing Rods (MAGEC)

A new and innovative modality in treatment for growth-sparing surgeries is the use of Magnetic Controlled Growing Rods or MAGEC. With MAGEC, adjustments and corrections can be made without additional surgeries, offering a more convenient and less invasive option for young patients.

Scoliosis surgery is a transformative journey that offers hope for improved health, function, and confidence. With Dr. Rajat Mahajan, the best spine surgeon in Delhi, by your side, you can trust that you are in capable hands. From the initial consultation to post-operative care and beyond, Dr. Mahajan and his team are dedicated to your well-being. Book an appointment today.