New corrective spine surgery less invasive for teenagers with scoliosis

Sep 6 2011
Adolescents with scoliosis can now undergo a corrective spine surgery that is less invasive than the current standard operation, but equally effective in relieving symptoms of the condition, which may include back pain.

The abnormal curvature of the spine known as scoliosis affects up to 3 percent of the U.S. population, totaling an estimated 6 million people, according to the National Scoliosis Foundation. The onset of scoliosis is usually between the ages of 10 and 15 years old. Both boys and girls can be affected, but girls are at a greater risk of an abnormal curvature that is bad enough to require treatment. In most cases, doctors don't know what causes scoliosis. The condition can inflict pain, affect heart and lung function and hurt self-esteem. Radiation exposure from x-rays, particularly to the breasts of girls, is also a considerable hazard, according to the U.S. Food and Drug Administration. Individuals who screen positive for scoliosis may require follow-up x-rays several times a year.

Every year, 30,000 children are put in back braces, and another 38,000 patients undergo corrective surgery, as reported by the National Scoliosis Foundation. In the past, minimally invasive procedures were available only to adults. Open back surgery was the only option available to younger patients, during which the doctor makes a two-foot long incision along the spine and straightens it with rods, screws and bone grafts.

Vishal Sarwahi, MD, director of Spine Deformity Surgery at Montefiore Medical Center at New York's University Hospital for Albert Einstein College of Medicine, has now made the minimally invasive procedure possible for adolescents with scoliosis, correcting the spine using only three small incisions. Compared to the open back procedure, the new one causes less blood loss, demands less pain medication and requires a shorter hospital stay, according results published in the August 2011 issue of the journal Scoliosis.

The best candidates for the new procedure are patients with a curvature of the spine between 40 and 70 degrees, Sarwahi said. Compared to adults, there are more technical challenges in performing the minimally invasive surgery in adolescents because their scoliosis can be more severe and there are more vertebra to fuse.

Sarwahi operated on seven individuals already. The minimally invasive procedure currently requires more time than the open back procedure for adolescents, but surgeons hope the time will be reduced when they gain more experience. The results from the first surgeries were comparable to those of the traditional procedure, Sarwahi said.