Closer Look: Scoliosis Surgery

, c;lToday, I was able to assist in a Scoliosis Surgery. I was only able to assist in this surgery once and in what I remember, it's one of the long surgeries done in OR. Anyways, here's a closer look in this surgery.

SCOLIOSIS SURGERY

Definition: Surgery for adolescents with scoliosis is only recommended when their curves are greater than 40 to 45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees. Scoliosis surgery is designed to reduce the patients curvature and fuse the spine to prevent any further progression of the deformity.

Besides preventing further curvature, scoliosis surgery can also reduce the amount of deformity. Usually, about a 50% correction can be obtained with surgery using modern instrumentation systems in which hooks and screws are applied to the spine to anchor long rods. The rods are then used to reduce and hold the spine while bone that is added fuses together.

 

Procedure:

Surgery involves an incision in the posterior aspect of the spine. The child lies on their stomach as the procedure is performed. The length of the incision will be based on the location and extent of the curvature. The muscles of the spine are moved in order for the surgeon to access the spinal column. 

Surgery for scoliosis is a form of spinal fusion. Rods and screws are connected to the individual vertebrae and a wire is often used to help realign and straighten the curve. The use of Harrington rods are a common fixation device for this type of fusion.

In many cases, a bone graft is used to connect one vertebra to another to form one segment and provide additional strength to keep the bones in place. Although donor bone material may be used, the surgeon may harvest bone to be used for this bone graft from the child’s pelvis (called an autograft). Generally bone that comes from a synthetic form or donor is not as successful as the autograft. Scoliosis surgery is involved and generally takes 4 to 6 hours to perform, depending on the specific case.

Instruments and Supplies:

• Sharps
• Kelly
• ochsner straight
• freer
• wetlainer (curve)
• adson-beckman retractor
• rongeur/ gooseneck
• mallet
• harrington/cobbs
• cottonoids
• 2/3s
• rubber sheet
• bone wax
• cautery tip
• NST
• Suction tube
• curette
• sterile cover for C-arm
• PDS OCT1
• Vicryl OCT1
• Vicryl 2-0
• Prolene 4-0
• osteotome
• bone gouge

Sources: Scoliosis Surgery, Spine Health