Interventional procedure overview of minimally invasive fusionless posterior-approach surgery to correct idiopathic scoliosis in children and young people
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What the procedure involves
Minimally invasive fusionless posterior approach surgery is intended to correct idiopathic scoliosis in selected people aged 8 years to 17 years whose bones have not fully matured. It is mainly used for correction of flexible single curves (a thoracic major curve or thoracolumbar major curve) measuring up to 60 degrees.
The procedure is done under general anaesthesia and fluoroscopic guidance using a posterior unilateral approach. The concave side of the spinal curve is exposed through an incision around the apex of the curve. Two pedicle screws are inserted into the vertebral bodies through the pedicle above and below the apex of the spinal curvature to serve as anchor points. A self-adjusting ratchet rod with an extender and 2 polyaxial joints (that allow a degree of spinal motion) is then fixed to the spine with pedicle screws that are implanted around the apex of the curve. Distraction during surgery is applied with a manual instrument to expand the rod and to straighten the spine. After the procedure people are allowed to weight bear during everyday activities.
About 2 to 3 weeks after surgery, people are advised to exercise daily. This is to allow the self-adjusting rod additional unilateral elongation so there may be further gradual straightening of the spine while the person continues to grow. Because the procedure does not involve any spinal fusion, spinal motion is preserved. This minimises length of hospital stay and recovery time.
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