When a young person exhibits a worsening spinal deformity, surgical treatment may be indicated to improve the deformity and to prevent increasing deformity in the future. The most common surgical procedure is a posterior spinal fusion with instrumentation and bone graft. The term "instrumentation" refers to a variety of devices such as rods, hooks, wires, and screws, which are used to hold the correction of the spine in as normal an alignment as possible while the bone fusion heals. The instrumentation is rarely removed.
A number of factors influence the recommendation for surgery:
1. The area of the spine involved;
2. Severity of the scoliosis;
3. Presence of increased or decreased kyphosis;
4. Pain (rare in adolescents, more common in adults);
5. Growth remaining; and
6. Personal factors.
Operative Considerations
The goal of surgery is to fuse the spine at the optimum degree of safe correction of the deformity. There are always risks that accompany any surgical procedure. These should be discussed with your orthopaedic surgeon. Some important points in planning your surgery are:
1. A comprehensive preoperative conference
2. Donating your own blood (if possible)
3. Good nutritional status before and after surgery
4. Exercise program before and after surgery
5. Positive mental attitude
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