SCOLIOSIS SURGERY: ANTERIOR APPROACH LIVING WITH SCOLIOSIS

WHAT IS THE ANTERIOR APPROACH?

In the anterior spinal surgery for scoliosis, the surgeon will access the spinal column from the front rather than through the back. Technically, the surgeon makes the actual incisions in the side of the chest or abdomen rather than down the front of the body. Using the anterior approach, surgeons can remove discs from the front of the spine (if necessary), place corrective spinal instrumentation, and perform the correction.

WHEN IS THIS APPROACH USED?

A variety of factors influence the decision to use the anterior approach for scoliosis surgery. Among them include the patient’s type of scoliosis, location of spinal curvature, severity of the curve, ease of approach to the area, and the surgeon’s preference. The anterior approach is especially conducive to certain types of scoliosis curves, such as those located in the thoracolumbar spine (thoracic and lumbar regions).

Anterior techniques can be a very effective method of correcting spinal deformities. In a scoliosis procedure, the surgeon may be able to fuse a shorter segment of the spine with this approach, thus preserving more motion in the spinal column. 

about the OPERATION

After a person enters the operating room, they will be given anaesthesia to put them to sleep. Once completely asleep, the anaesthesiologist will place a breathing tube to assist breathing during the operation. He or she will also place a variety of catheters in veins used to monitor heart function, blood pressure, fluid status, and depth of anaesthesia throughout surgery. The patient will then be rolled onto their side.

THE INCISION

A surgeon will make an incision on the side of the patient, either over the chest or lower along the abdomen, depending on the part of the spine that requires correction. In order to access the sine, the surgeon will deflate one lung and remove a rib.

SPINAL PREPARATION

Once the surgeon has exposed the surface of the spinal column, he or she will remove the disc material from between the vertebra involved in the scoliosis curve. This increases the curve’s flexibility and provides a large surface area for spinal fusion. Disc removal is an important feature of the anterior approach.

SCREW AND ROD PLACEMENT

To complete the scoliosis correction, the surgeon will place a vertebral body screw at each vertebral level involved in the spinal curve. At each level, these screws will be attached to a single or double rod. By compressing and rotating the rod, the surgeon will correct the curve and straighten the spine.

FUSION

After final adjustments have been made to the screws and rods, the surgeon will perform spinal fusion. He or she will first roughen the bony surface between the vertebrae, then pack bone graft into the space between the vertebral bodies. Bone graft may be gathered from the removed rib, the crest of your pelvis, allograft bone, or other bone substitutes. The bone graft helps the vertebrae to heal together into a solid bone.

INCISION CLOSURE

After the bone graft and fusion, the surgeon closes and dresses the wound. If the surgeon was working in the chest cavity, they will place a chest tube to help keep the lung expanded after the operation.