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Alternative NamesSpinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child
Definition Return to top
Scoliosis surgery repairs abnormal curving of the spine (scoliosis). The goal is to safely straighten the spine, align your child’s shoulders and hips, and give you long-term correction for your child’s back problem.
Description Return to top
Before surgery, your child will receive general anesthesia. This will make your child unconscious and unable to feel pain during the operation.
During surgery, your child’s surgeon will use steel rods, hooks, or other metal devices to straighten your child’s spine and support the bones of the spine. Then the surgeon will use bone grafts to hold the spine in the correct position and keep it from curving again.
Your child’s surgeon will make at least 1 incision (cut) to get to your child’s spine. This incision may be in your child’s back, chest, or both places. The surgeon may also do the procedure using a special video camera.
The surgeon will move muscles aside after making the incision. The joints between the different vertebrae (the bones of the spine) will be taken out. Bone grafts will be put in to replace them. Metal instruments, such as rods, screws, hooks, or wires, will also be placed to help hold the spine together until the bone grafts fuse (attach) and heal completely.
The surgeon may get bone for the grafts in these ways:
Different surgeries use different types of metal instruments. These are usually left in the body after the bone fuses together. Three of the more common procedures are:
During surgery, the nerves that come from the spine will be watched using special equipment to make sure no damage is done to any of the nerve roots.
Scoliosis surgery usually takes 4 to 6 hours. It may be longer or shorter for some children.
Why the Procedure is Performed Return to top
Appearance is usually a major concern for anyone with scoliosis. Scoliosis also often causes back pain. If the curve is severe enough, scoliosis may affect your child’s breathing.
The choice of when to have surgery will vary. After the bones of the skeleton stop growing, the curve should not get much worse. Because of this, the surgeon may want to wait until your child’s bones stop growing. But your child may need surgery before this if the curve in their spine is severe or is getting worse quickly.
Risks Return to top
There may be complications with any of the procedures for scoliosis repair.
Risks for any anesthesia are:
Risks for any surgery are:
Possible complications from any scoliosis repair surgery are:
Before the Procedure Return to top
Always tell your doctor or nurse what drugs your child is taking, even drugs, supplements, or herbs you bought without a prescription.
Before the operation:
During the 2 weeks before the surgery:
On the day of the surgery:
The doctor or nurse will tell you when to arrive at the hospital.
After the Procedure Return to top
Your child will need to stay in the hospital for 3 to 4 days after surgery. The repaired spine should be kept in its proper position to keep it aligned. If the surgery involved an incision in the chest, your child may have a tube in their chest to drain fluid build-up. This tube is usually removed after 24 to 72 hours.
A catheter (tube) may be placed in your child’s bladder the first few days to help them urinate.
Your child’s stomach and bowels may not work for a few days after surgery. Your child may need to receive fluids and nutrition through an intravenous (IV) line.
Your child will receive pain medicine in the hospital. At first, pain medicine may be delivered through a special catheter inserted into your child’s back. After that, your child may use a pump to control how much pain medicine they get. Your child may also get shots or take pain pills.
Your child may have a cast or a brace.
Outlook (Prognosis) Return to top
Your child’s spine should look much straighter after surgery. But there will still be some curve. It takes at least 3 months for the spinal bones to fuse together well. It will take 1 to 2 years for them to fuse completely.
Fusion stops growth in the spine. This is not usually a concern because most growth occurs in the long bones of the body, such as the leg bones. People who have this surgery will probably gain height from both growth in the legs and from having a straighter spine.
References Return to top
Hedequist DJ. Surgical treatment of congenital scoliosis. Orthop Clin North Am. 2007;38(4):497-509.
Lonner, B. S. Emerging minimally invasive technologies for the management of scoliosis. Orthop Clin North Am. 2007;38(3): 431-440.
Patil CG, Santarelli J, Lad SP, et al. Inpatient complications, mortality, and discharge disposition after surgical correction of idiopathic scoliosis: a national perspective. Spine J. 2008 Mar 19 [Epub ahead of print]Update Date: 2/2/2009 Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.