My Spine - Lumbar
A thorough history of other medical problems and medication used is needed
to minimise complications. There are various surgical options with increasing
complexity and risk. The following procedures are available.
Anterior release
Anterior means from the front and describes an approach either through the
chest or abdomen. The release is never done as the only procedure and needs
to be followed by a stabilisation operation.
The release increases the flexibility of the skew spine. It is indicated in
patients with an extremely rigid spinal curve, which is not easily correctable.
If the scoliosis is in the thoracic (chest) spine, this requires an approach
through the chest. Here, an oblique incision is made in line with one of the
ribs, the chest opened, the lung moved to the side and the spine inspected. The
intervertebral discs are then removed from between the vertebral bodies to
allow more spinal movement and to encourage bony growth between the ver-
tebrae at a later stage. Some of the rib heads may be resected to further
increase the flexibility.
The patient needs to have a chest drain (intercostal drain) inserted post-oper-
atively to drain the air and blood and patients can expect a degree of discom-
fort for a few weeks due to the motion of breathing that causes movement at
the repaired rib entry site.
Anterior corrective fusion
Should the curve be readily correctable, as assessed pre-operatively with
dynamic X-rays and a clinical examination, the whole corrective process can
be done with surgery from the front. This is typical for lumbar (lower back)
scoliosis. In this instance the discs are removed as above, but in addition
screws are placed into each vertebral body and connected with a rod. During
this process the skew spine is forced to connect to a straight rod and thus
straightened out. This technique has the advantage of minimal blood loss and
muscle damage.
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