DAVE WATTS, MD
Spinal Deformity Surgery
The spinal cord is responsible for providing stability to the human body and plays a significant role in keeping the body upright. There are several irregular shaped bones in the spine, which join the spinal cord to make it look straight.
There are two gentle curves in the spinal cord. When these curves become miss-aligned, they cause serious health problems like breathing difficulties, fatigue, and back pain. These conditions are considered as symptom of a deformity in the shape, curvature or flexibility of the spine.
These are the different types of spinal deformities found in patients.
This spine deformity is caused by backbone curving sideways. The “S” or “C” shaped curve usually refers to scoliosis.
The abnormal curvature of the spinal cord causes Lordosis, also known as swayback.
Kyphosis is a spinal cord deformity due to an abnormal curvature of the spine caused by the thoracic or chest region. This deformity makes the spinal cord look like a round back.
Treatments for Spinal Cord Deformities
These are some of the standard ways to treating these spinal cord deformities.
In this surgical procedure, the physician approaches the spine from the front. An incision is made to the patient’s side, through the chest wall or lower down the abdomen. The lung is deflated, and the physician removes a rib to reach the spine. Once the doctor has successfully exposed the spine column, disc material between vertebra responsible for the curve is removed.
The physician places screws at each vertebral level in the curve and uses them to attach a single or double rod at each level. After the doctor has performed fusion, the bony surface between vertebrae bodies is roughened to place a bone graft. The surgeon uses compression along the rod and rotates it to correct the spine deformity. The physician closes the incision upon completion of the surgery.
The more traditional approach to treating these types of spinal deformities is a posterior approach. The patient lies on their stomach while the doctor approaches from the back. The doctor makes an incision down the middle of the back and uses hooks to attach the back of the spine on the lamina. Screws are used in the midst of the spine.
After successfully placing hooks and screws, the surgeon uses bent and contoured rod for a more normal alignment. This rod helps correct the align and stabilize the spine. After the doctor has successfully tightened the screws, the incision is closed and dressed.
Anterior and Posterior Approach
A combination of anterior and posterior approach is used when the curve is stiff and severe. The surgeon makes the first approach to spinal column from the front to make an incision on patient’s side over the chest wall or lower down the abdomen. The disc material between vertebrae is removed. This procedure requires removal of a rib for bone grafting.
Once the anterior procedure is performed, the wound is closed, and the patient is positioned for the posterior approach. The surgeon makes an incision in the middle of the back to attach hooks on the lamina and place screws in the middle of the spine. The surgeon places hooks and screws to place a bent and contoured rod to facilitate a normal alignment of the spine and performs the correction. The wounds are closed after final tightening of screws.
Video-Assist Thoracoscopic Surgery (VATS)
VATS is a minimally invasive technique performed using a small video camera. The patient lies on their side. The surgeon makes four incisions of 1 inch each on the side of the chest wall. The surgeon inserts a thoracoscope (a thin instrument with a tiny camera and light at its end) using the incision. This device helps transfer images of the inside of the patient’s chest onto a video monitor. These images guide the surgeon to perform the procedure. The surgeon uses retractor, suction, and other surgical instruments through the incisions to perform the procedure.
There are several steps involved in this procedure including removal of the intervertebral disc, bone grafting, and instrumentation. The doctor deflates the lung to gain access to the spine and uses an absorbable suture to close the incisions and re-inflate the deflated lung.