Scoliosis | Scoliosis Surgery | Nucleus Health

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The spine is made up of bones called vertebrae, which are stacked on top of each other. The

vertebrae protect a bundle of nerve fibers called the spinal cord. It runs through an

opening in the center of each vertebra. The main sections of the spine are the cervical,

thoracic, and lumbar regions. Looking at it from the side, the spine normally has three

curves: A “C” in the cervical spine, a reverse “C” in the thoracic spine, and

another “C” in the lumbar spine. Viewed from behind, the spine should appear to be

completely straight up and down. Scoliosis is a condition where the spine has an abnormal

side to side curve. Most cases of scoliosis have no known cause. In some cases, scoliosis

may be present at birth. In other cases, it may occur over time—the most common cause

in adults is asymmetric degeneration of the discs, causing the spine to be tilted to one

side or the other. Other causes may include cerebral palsy, paralysis, muscular dystrophy,

osteoporosis, or spinal fractures. During childhood, the spinal curve usually becomes

worse during periods of rapid growth. If the curve becomes severe, it can cause problems

with posture, walking, and back pain. It can also cause the internal organs to become cramped

for space, causing heart, breathing, and digestion problems. Scoliosis is often treated with

a brace to stop the curve from getting worse. Doctors will measure the spinal curve over

time to see if the brace is working. For an adolescent, a surgical procedure may be necessary

if the brace isn’t working, or if a brace is not an option. For an adult with scoliosis,

a surgical procedure may be necessary if they are experiencing numbness or weakness in their

legs, or if they are having progressively worse back pain that does not improve with

nonsurgical treatments. The most common surgical procedure to repair scoliosis is called posterior

spinal fusion with instrumentation and bone grafting. To begin, the surgeon will make

an opening over the area of the curve in the spine. The surfaces of the vertebrae will

be roughened to help stimulate the bones to heal together. The surgeon will place screws,

hooks, or wires into the vertebrae. Rods will be placed alongside the vertebrae and attached

to the screws, hooks, or wires in order to straighten the spine. The surgeon may remove

small pieces of bone from the ribs or hip bone to use as grafts. Other times, the surgeon

may choose to use donor bone from a bone bank for grafting. The surgeon will place the bone

grafts along the spine to allow the bone to grow together and keep the spine stable. At

the end of the procedure, the skin incision will be closed with stitches.