Abnormal lateral curvatures of spine, Also see Alignment of Individual, Distortion, and Lumbar Vertebrae Deformed.Encyclopedia Entry for Scoliosis :Scoliosis - resources. Resources - scoliosis.Scoliosis Scoliosis.Encyclopedia Entry for Scoliosis :Scoliosis surgery - child. Before surgery, your child will receive general anesthesia. These are medicines that put your child into a deep sleep and unable to feel pain during the operation. During surgery, your child's surgeon will use steel rods, hooks, screws, or other metal devices to straighten your child's spine and support the bones of the spine. Bone grafts are placed to hold the spine in the correct position and keep it from curving again. The surgeon will make at least one surgical cut to get to your child's spine. This cut may be in your child's back, chest, or both places. The surgeon may also do the procedure using a special video camera. A surgical cut in the back is called the posterior approach. This surgery often takes several hours. A cut through the chest wall is called a thoracotomy. The surgeon makes a cut in your child's chest, deflates a lung, and often removes a rib. Recovery after this surgery is often faster. Some surgeons do both of these approaches together. This is a much longer and more difficult operation. Video-assisted thoracoscopic surgery (VATS) is another technique. It is used for certain kinds of spinal curves. It takes a lot of skill, and not all surgeons are trained to do it. The child must wear a brace for around 3 months after this procedure. During the surgery: The surgeon will move muscles aside after making the cut. The joints between the different vertebrae (the bones of the spine) will be taken out. Bone grafts will often be put in to replace them. Metal instruments, such as rods, screws, hooks, or wires will also be placed to help hold the spine together until the bone grafts attach and heal. The surgeon may get bone for the grafts in these ways: The surgeon may take bone from another part of your child's body. This is called an autograft. Bone taken from a person's own body is often the best. Bone can also be taken from a bone bank, much like a blood bank. This is called an allograft. These grafts are not always as successful as autografts. Manmade (synthetic) bone substitute may also be used. Different surgeries use different types of metal instruments. These are usually left in the body after the bone fuses together. During surgery, the surgeon will use special equipment to keep an eye on the nerves that come from the spine to make sure they are not damaged. Scoliosis surgery often takes 4 to 6 hours.Braces are often tried first to keep the curve from getting worse. But, when they no longer work, the child's health care provider will recommend surgery. There are several reasons to treat scoliosis: Appearance is a major concern. Scoliosis often causes back pain. If the curve is severe enough, scoliosis affects your child's breathing. The choice of when to have surgery will vary. After the bones of the skeleton stop growing, the curve should not get much worse. Because of this, the surgeon may wait until your child's bones stop growing. Your child may need surgery before this if the curve in the spine is severe or is getting worse quickly. Surgery is often recommended for the following children and adolescents with scoliosis of unknown cause (idiopathic scoliosis): All young people whose skeletons have matured, and who have a curve greater than 45 degrees. Growing children whose curve has gone beyond 40 degrees. (Not all doctors agree on whether all children with curves of 40 degrees should have surgery.).There may be complications with any of the procedures for scoliosis repair. Risks of anesthesia and surgery in general are: Reactions to medicines or breathing problems Bleeding , blood clots , or infection Risks of scoliosis surgery are: Blood loss that requires a transfusion. Gallstones or pancreatitis (inflammation of the pancreas) Intestinal obstruction (blockage). Nerve injury causing muscle weakness or paralysis (very rare) Lung problems up to 1 week after surgery. Breathing may not return to normal until 1 to 2 months after surgery. Problems that may develop in the future include: Fusion does not heal. This can lead to a painful condition in which a false joint grows at the site. This is called pseudarthrosis. The parts of the spine that are fused can no longer move. This puts stress on other parts of the back. The extra stress can cause back pain and make the disks break down (disk degeneration). A metal hook placed in the spine may move a little. Or, a metal rod may rub on a sensitive spot. Both of these can cause some pain. New spine problems may develop, largely in children who have surgery before their spine has stopped growing.Tell your child's provider what medicines your child is taking. This includes medicines, supplements, or herbs you bought without a prescription. Before the operation: Your child will have a complete physical exam by the doctor. Your child will learn about the surgery and what to expect. Your child will learn how to do special breathing exercises to help the lungs recover after surgery. Your child will be taught special ways to do everyday things after surgery to protect the spine. This includes learning how to move properly, changing from one position to another, and sitting, standing, and walking. Your child will be told to use a 'log-rolling' technique when getting out of bed. This means moving the entire body at once to avoid twisting the spine. Your child's provider will talk with you about having your child store some of their blood about a month before the surgery. This is so that your child's own blood can be used if a transfusion is needed during surgery. During the 2 weeks before the surgery: If your child smokes, they need to stop. People who have spine fusion and keep smoking do not heal as well. Ask the doctor for help. Two weeks before surgery, the doctor may ask you to stop giving your child medicines that make it harder for the blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn). Ask your child's doctor which medicines you should still give your child on the day of the surgery. Let the doctor know right away when your child has any cold, flu, fever, herpes breakout, or other illness before the surgery. On the day of the surgery: You will likely be asked not to give your child anything to eat or drink 6 to 12 hours before the procedure. Give your child any medicines the doctor told you to give with a small sip of water. Be sure to arrive at the hospital on time.Your child will need to stay in the hospital for about 3 to 4 days after surgery. The repaired spine should be kept in its proper position to keep it aligned. If the surgery involved a surgical cut in the chest, your child may have a tube in the chest to drain fluid buildup. This tube is often removed after 24 to 72 hours. A catheter (tube) may be placed in the bladder the first few days to help your child urinate. Your child's stomach and bowels may not work for a few days after surgery. Your child may need to receive fluids and nutrition through an intravenous (IV) line. Your child will receive pain medicine in the hospital. At first, the medicine may be delivered through a special catheter inserted into your child's back. After that, a pump may be used to control how much pain medicine your child gets. Your child may also get shots or take pain pills. Your child may have a body cast or a body brace. Follow any instructions you are given on how to care for your child at home.Your child's spine should look much straighter after surgery. There will still be some curve. It takes at least 3 months for the spinal bones to fuse together well. It will take 1 to 2 years for them to fuse completely. Fusion stops growth in the spine. This is not often a concern because most growth occurs in the long bones of the body, such as the leg bones. Children who have this surgery will probably gain height from both growth in the legs and from having a straighter spine.Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child.Thomas MA, Therattil M. Scoliosis and kyphosis.Encyclopedia Entry for Scoliosis :Scoliosis. Most of the time, the cause of scoliosis is unknown. This is called idiopathic scoliosis. It is the most common type. It is grouped by age. In children age 3 and younger, it is called infantile scoliosis. In children age 4 through 10, it is called juvenile scoliosis. In children age 11 through 18, it is called adolescent scoliosis. Scoliosis most often affects girls. Some people are more likely to have curving of the spine. Curving generally gets worse during a growth spurt. Other types of scoliosis are: Congenital scoliosis: This type of scoliosis is present at birth. It occurs when the baby's ribs or spine bones do not form properly. Neuromuscular scoliosis: This type is caused by a nervous system problem that affects the muscles. Problems can include cerebral palsy , muscular dystrophy , spina bifida, and polio.Most often, there are no symptoms. Signs of scoliosis If there are symptoms, they may include: Backache or low-back pain that goes down the legs Weakness or tired feeling in the spine after sitting or standing for a long time Uneven hips or shoulders (one shoulder may be higher than the other) Spine curves more to one side.The health care provider will perform a physical exam. You will be asked to bend forward. This makes your spine easier to see. It may be hard to see changes in the early stages of scoliosis. Forward bend test The exam may show: One shoulder is higher than the other The pelvis is tilted X-rays of the spine are done. X-rays are important because the actual curving of the spine may be worse than what your doctor can see during an exam. Other tests may include: Spinal curve measurement (scoliometer screening) MRI of the spine CT scan of the spine to look at the bony changes.Treatment depends on many things: The cause of scoliosis Where the curve is in your spine How big the curve is If your body is still growing Most people with idiopathic scoliosis do not need treatment. But you should still be checked by a doctor about every 6 months. Scoliosis brace If you are still growing, your doctor might recommend a back brace. A back brace prevents further curving. There are many different types of braces. What kind you get depends on the size and location of your curve. Your provider will pick the best one for you and show you how to use it. Back braces can be adjusted as you grow. Back braces work best in people over age 10. Braces do not work for those with congenital or neuromuscular scoliosis. Spinal fusion You may need surgery if the spine curve is severe or getting worse very quickly. Surgery involves correcting the curve as much as possible: Surgery is done with a cut through the back, belly area, or beneath the ribs. The spine bones are held in place with 1 or 2 metal rods. The rods are held down with hooks and screws until the bone heals together. After surgery, you may need to wear a brace for a while to keep the spine still. Scoliosis treatment may also include: Emotional support: Some children, especially teens, may be self-conscious when using a back brace. Physical therapy and other specialists to help explain the treatments and make sure the brace fits correctly.Seek support and more information from organizations that specialize in scoliosis.How well a person with scoliosis does depends on the type, cause, and severity of the curve. The more severe the curving, the more likely it will get worse after the child stops growing. People with mild scoliosis do well with braces. They usually do not have long-term problems. Back pain may be more likely when the person gets older. Outlook for those with neuromuscular or congenital scoliosis varies. They may have another serious disorder, such as cerebral palsy or muscular dystrophy, so their goals are much different. Often, the goal of surgery is simply to allow a child to be able to sit upright in a wheelchair. Congenital scoliosis is difficult to treat and usually requires many surgeries.Complications of scoliosis can include: Breathing problems (in severe scoliosis) Low back pain Lower self-esteem Persistent pain if there is wear and tear of the spine bones Spinal infection after surgery Spine or nerve damage from an uncorrected curve or spinal surgery Leakage of spinal fluid.Call your provider if you suspect your child may have scoliosis.Routine scoliosis screening is now done in middle schools. Such screening has helped detect early scoliosis in many children.Spinal curvature; Infantile scoliosis; Juvenile scoliosis.Anesthesia - what to ask your doctor - child.Scoliosis Scoliosis Skeletal spine Skeletal spine Scoliosis Scoliosis Spinal curves Spinal curves Signs of scoliosis Signs of scoliosis Forward bend test Forward bend test Scoliosis brace Scoliosis brace Spinal fusion Spinal fusion.Mistovich RJ, Spiegel DA. The spine.