Spinal Deformity Correction Surgery
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Spinal Deformity Treatment in Pimpri Chinchwad
“Deformity correction is the surgical adjustment or modification of bone that grows incorrectly as the result of a disease or condition, such as bowlegs or knock knee.“
Spinal deformity is a complex and dynamic change that occurs in the sagittal, coronal or planes. There are two types of spinal deformity : coronal plane deformations (scoliosis) and sagittal plane deformations (kyphosis). They can appear alone or in combination. The interaction between coronal and sagittal curvature is a dynamic process. Successful treatment aims to achieve a satisfactory balance on both planes. Spinal deformity surgery is a complicated operation with a high frequency of complications. The primary goal of deformity surgery is to achieve a balanced spinal alignment through rigid fusion, prevent further deformity and alleviate neurological symptoms. A secondary goal of spinal deformity surgery is to improve appearance for cosmetic purpose.
Some patients with spinal deformity are treated conservatively or palliative care, such as medications, braces, and exercises. Other deformity patients may undergo limited decompression and fusion surgeries. The main indication for adult spinal deformity surgery is severe pain associated with the curve progression. The character of the pain may be axial back pain, radiating pain or a combination. Other indications are progression of the deformed curve and spinal decompensation. In the adolescent patients, deformity progression and cosmetic factor (poor appearance) are the most common indications for spinal deformity surgery. Decreased pulmonary function is also indicated for spinal deformity surgery.
Scoliosis
a side-to-side curve in the spine. Classifications include
- Congenital: a form of scoliosis present at birth
- Infantile: scoliosis that occurs in patients 0–3 years old
- Juvenile: scoliosis that occurs in patients 4–10 years old
- Adolescent: scoliosis that occurs in patients 11–18 years old
- Adult: adult scoliosis may be idiopathic or degenerative in cause
Kyphosis
Spinal deformity in which the spine curves excessively outward, creating the appearance of a hunchback. Occasionally called hyperkyphosis, to differentiate it from the normal kyphosis of the thoracic spine.
- Chin on chest syndrome: cervical and upper thoracic kyphosis that is so severe the chin drops to the chest. Also referred to as dropped head syndrome or head ptosis.
- Lordosis: a rare spinal deformity in which the lower back curves excessively inward. Occasionally called hyperlordosis to differentiate it from the normal lordosis of the lumbar spine. Hyperlordosis may occur to compensate for hyperkyphosis elsewhere.
- Flatback syndrome: spinal deformity in which the lumbar spine loses its normal lordosis.
Symptoms
Signs of scoliosis may include a difference in shoulder or hip height, a difference in the way the arms hang beside the body, a spine that is visibly off-center, or a head that appears off-center with the body. Signs of sagittal imbalance may include a stooped forward posture, a hump in the back, or an inability to stand up straight.
Symptoms can be felt by the person with the condition. Symptoms of scoliosis vary: most cases of infantile, juvenile, and adolescent scoliosis, for example, produce no symptoms. Degenerative scoliosis is often accompanied by pain. Symptoms of sagittal imbalance range from mild discomfort to severe pain. Spinal deformities also have the capacity to interfere with the spinal cord or nerve roots. Stretch or compression of the spinal cord or nerve roots produces symptoms that may include pain, weakness, numbness, or tingling that travel down an arm or a leg.
Diagnosis
To establish the existence and extent of spinal deformity, the following tests may be useful:
- X-ray
- Magnetic resonance (MR) imaging
- Computed tomography (CT) scan
Treatments
Surgery is considered if:
- The patient experiences severe pain that is not relieved by physical therapy, bracing, and/or pain medications
- The spinal deformity is progressing
- The condition has caused a physical deformity that is unbearable to the patient
- The condition has caused compression of the spinal cord or nerve roots
- The deformity has resulted from fractures, usually caused by osteoporosis
- The deformity is of such a magnitude that it is likely to progress even once skeletal growth is complete
