Stapling for scoliosis

April 13, 2009 Although the spine appears in the form of an elongated "S" from the side, it normally appears as a straight line when viewed from behind. Scoliosis is a term to describe an abnormal curvature of the spine, or when the spine looks like an "S" or a "C" from behind. The Scoliosis Research Society says in 80 percent of cases, no specific cause is found for the condition. However, causes that have been linked to scoliosis include congenital spinal column abnormalities and neurological disorders. The condition can't be corrected by learning to stand up straight and it isn't caused by carrying heavy things, bad posture or athletic activity.

SYMPTOMS: Although an abnormally curved spine may not be visible without x-rays, the following symptoms may mean you have scoliosis: uneven shoulders, an uneven waist, leaning to one side, one shoulder blade that appears more prominent than the other, and fatigue. Severe scoliosis can cause back pain and difficulty breathing.

TREATMENTS: Treatment for scoliosis is different from case to case. For small curves in children and moderate curves in adults, observation -- and sometimes physical therapy -- is recommended. For curves of between 25 and 45 degrees in children, bracing is often recommended to stop progression of scoliosis. Braces are made of plastic and contoured to fit the body. Underarm braces fit under the arms and around the rib cage, lower back and hips. Milwaukee braces have a neck ring with rests for the chin and the back of the head and are designed to correct curves in the upper spine. For severe cases of scoliosis, which the National Institutes of Health says are greater than 40 degrees, surgery is often the best course of treatment. Surgery involves correcting the curve and fusing the bones in the curved part of the spine together. The bones are held in place with metal rods held down with hooks and screws until fusion occurs. Unfortunately, surgery like this stops growth in the portion of the spine that is operated on. Other complications can include bleeding, infection, pain, nerve damage, arthritis and disk degeneration. To address the problem of halted growth after spine fusion surgery, researchers at the Mayo Clinic are testing a scoliosis treatment that uses "growing rods." The rods are adjustable, and surgeons periodically lengthen the rods to accommodate growth. Another new surgical technique that corrects scoliosis involves staples. The spinal stapling procedure takes two hours. During surgery, inch-long staples made of a high-tech temperature-sensitive metal alloy are implanted using a camera called a thoracoscope. Children with a curvature of less than 30 degrees who are still growing are candidates for the procedure.


Ana Lucia
Associate Professor of Pediatric Orthopaedic Surgery
Columbia University Medical Center
3959 Broadway - 8 North
New York, NY 10032
(212) 305-5475

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