Scoliosis & Deformity Surgeries
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Scoliosis & Deformity Surgeries
Spinal deformities include scoliosis, kyphosis and their combinations. The correction of these deformities is a complex surgical procedure and needs expertise, experience and equipments. All deformity surgeries are performed under fluoroscopic guidance with the aid of neuromonitoring. Complex deformity correction surgeries around the spinal cord entail a 1% risk of potential injury to the spinal cord depending on the severity of the deformity and existing neurological compromise. Previously such problems were identifiable only at the end of surgery after the patient awakens from anaesthesia. This problem has been greatly reduced by the availability of spinal monitoring system. Spinal cord monitoring systems enable immediate identification of potential injury to the spinal cord during such surgeries. They can detect even small changes in the signals during the surgery so that serious injury to the spinal cord could be prevented.
Using x-ray guidance, a 2- to 4-cm incision is made approximately 4 to 5 cm lateral to the midline. The muscles are gradually dilated and a tubular retractor inserted to allow access to the affected area of the lumbar spine. The lamina is removed to allow visualization of the nerve roots, and the facet joints may be trimmed or removed to allow more room for the nerve roots. The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement. Surgeons may position small screws on the other side of the spine through a percutaneous technique to provide additional stability. The tubular retractor is removed, allowing the dilated muscles to come back together, and the incision is closed.
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