It's no wonder we talk so much about early detection and the possibility of conservative treatment to try to avoid the dreaded scoliosis surgery. Indeed, it is not easy to go through. I am part of the statistics, and even with the use of a brace for almost 5 years, I couldn't escape surgery. As happened to me, many other children and teenagers have no choice, and the only way out is to undergo surgery. So, let's talk about it!
Recently, I attended the International Symposium of AACD, which, by the way, was wonderful, and much was discussed about scoliosis surgery. In this post, I will share with you a bit of what I learned there and also what I learned through research!
When is the time for surgery?
All cases should be discussed with your trusted orthopedist and spine surgeon, but typically, the recommendation is for surgery to occur for curves above 45 and 50 degrees. Obviously, factors will be assessed beforehand, such as the patient's age, type of curve, and indications of progression. I had surgery with a 60-degree curve at the age of 18, but when I discovered scoliosis at 11, my curve was around 30. I wore a brace and did all kinds of exercises, but even with growth completed, the deviation continued to grow, and that is what we call progressive scoliosis - endless growth that will inevitably compromise organs such as the lungs and heart. A classic case for surgery. There's no escaping it.
What are the main preparations for surgical treatment?
The most important thing before scoliosis surgery is to have a multidisciplinary team taking care of us. It's not enough to have an orthopedist and surgeon because many factors are involved, including psychological aspects. Among the professionals who should accompany us at this time are a nutritionist, psychologist, physiotherapist, anesthetist, and possibly an occupational therapist. Additionally, family support is extremely important to provide the necessary confidence before facing hours of complex surgery. We also need to be prepared for the pain we will feel during the postoperative - I had unbearable pain and lived on morphine. I was nowhere near prepared for that.
What is the most important result that the patient expects from surgery?
Level shoulders and a less noticeable hump, but this will vary case by case. As the bones of the spine protect the spinal cord, the surgeon will straighten the bones only as far as it is safe. The degree of correction depends on how flexible your scoliosis is before the operation, and in general, the more flexible the curve, the better the correction of the surgery. I swam for many years before surgery to make my spine more flexible.
Most patients recover from surgery with curves corrected to less than 25 degrees. In many cases, these small curves are almost imperceptible. I ended up with a bit more: 28 degrees.
In another post, I commented on the expectation of reducing the degrees of curvature to zero.
What about postoperative care?
Something discussed a lot at the AACD Symposium was the importance of taking very good care of wounds to prevent infection. In fact, we had an excellent lecture from one of the nurses at the Orthopedic Hospital, where the main theme was this. Still, in the field of wounds, it is important to avoid injuries from medical adhesives, that is, the adhesives used for bandages. Many burn the skin, as we see in the photo below. In addition, some types of medications should be avoided or doses should be reduced to prevent intestinal congestion in the patient. This is very common and causes immense discomfort.
Is there a less invasive technique than conventional scoliosis surgery?
Yes, the bipolar technique was developed in 2012 by the French doctor Lofti Miladi, who was present online at the AACD Symposium. He showed many cases of photos of patients who have already undergone surgery through this technique, where there is not a complete cut in the back but rather small incisions at strategic points. Among the benefits are less surgery time, less bleeding, a lower chance of infection, less painful postoperative process, and less radiation exposure.
Currently, there are several scientific papers published in renowned international journals that prove that the technique is safe and effective. Worldwide, more than two thousand surgeries using this innovative technique have been performed, including in Brazil.
So, the subject is endless, and therefore, we can talk much more about it! Feel free to comment and share your relationship with scoliosis surgery! Sharing experiences and information does help many other people who will still go through the process.
Comments