New Technique for Treating Scoliosis in Juveniles

A minimally invasive surgery option is now available to treat adolescent idiopathic scoliosis (AIS), according to a new report.

Developed at the Montefiore Medical Center (MMC; New York, NY, USA), the new procedure is intended for the treatment of teenagers with AIS, with routine spinal curvature of 40-70 degrees. The technique allows for the utilization of all standard reduction maneuvers through three small midline skin incisions. The technique allows for the easy passage of contoured rods, the placement of pedicle screws without image guidance, and also allows adequate facet osteotomy to enable fusion. The researchers have so far performed seven such procedures in over a year.

According to the researchers, there are multiple potential advantages to the technique, including less blood loss, shorter hospital stay, and earlier mobilization. The operative time needed to complete this surgery, however, is longer, and there several technical challenges, including the greater spinal curvature in adolescent patients (50% to 100% greater than in adults); a higher number of vertebra requiring fusion (7-13 vertebra); greater radiation exposure due to multiple X-rays required to help place screws in each of the vertebrae; and that the spine is twisted into three planes, which makes surgery more complex. The report was published in the August 2011 issue of Scoliosis.

“This new procedure to correct curvature of the spine involves three small incisions in the back, as opposed to standard open surgery, which requires a two-foot incision in the back,” said leadauthor Vishal Sarwahi, MD, director of spine deformity surgery at MMC. “While there are significant technical challenges in the new procedure, it has proved as effective as open surgery and involves less blood loss during surgery, shorter hospital stays, relatively less pain and pain medication, and helps patients become mobile sooner.”

Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional (3D) deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line. Scoliosis is typically classified as congenital, idiopathic, or neuromuscular when it has developed as a secondary symptom of another condition, such as spina bifida, cerebral palsy, spinal muscular atrophy, or physical trauma.

Related Links:
Montefiore Medical Center