Scoliosis correction surgery in children

This is an automatically translated article.

The article was professionally consulted with Master, Specialist I Tran Tuyen - Pediatrician - Department of Pediatrics - Neonatology, Vinmec Central Park International General Hospital.
Scoliosis is a disease caused by congenital or acquired abnormalities of the vertebrae, muscles and nerves. The characteristic symptom of the disease is that the spine is tilted to one side. Most cases of scoliosis in children do not require medical intervention. However, in severe cases, the child's body shape can be permanently deformed. Scoliosis surgery is considered an effective treatment in cases of severe scoliosis.

1. What is scoliosis correction surgery?

Scoliosis is defined as an abnormal curvature of the spine that causes deviation to one side and often for unknown reasons. In the long term, it deforms the spine causing hunchback, arching, stooping, curvature... In children. The most common cause of scoliosis in school children is usually caused by improper sitting posture, carrying too much weight, or the size of the desk and chair is not suitable for their age, due to rickets, malnutrition, trauma. Accidental injury...
Back scoliosis can be recognized through a number of signs and symptoms on the outside, however, to accurately determine the disease status and curvature of the scoliosis, Doctors need to perform some necessary laboratory tests such as digital X-ray, MRI.
Scoliosis surgery depends on the age of onset of the disease, the severity of the scoliosis deformity, the rate of progression of the deformities and in some cases the indication for scoliosis surgery depends on the location. of deformation. Most cases of idiopathic scoliosis are indicated for scoliosis surgery when the spine deformity is 45 degrees or more.

2. Indications - contraindications for scoliosis surgery

2.1. Indications Juvenile idiopathic thoracic scoliosis or thoracic or lumbar hinge segment scoliosis (Lenke I or V); Scoliosis angle g above 40 degrees and less than 70 degrees; Scoliosis angle of the back is from 35 degrees to 40 degrees, but the angle of scoliosis progresses quickly (over 10 degrees within 1 year, despite using a spinal orthopedic vest); Soft back scoliosis angle less than 30 degrees; Below 8 vertebrae need to weld bone; Welding bone is not too much T4, not too L1, these cases are often endoscopic surgical intervention to correct the crooked. 2.2. Contraindications Double breast curves; Hard chest curves (flexibility rate less than 50%, or correction angle over 30 degrees); Angle of the thoracic spine over 40 degrees; Having thoracic diseases (history: pleurisy, tuberculosis, recurrent pneumonia ...), poor lung function or a history of thoracic or retroperitoneal surgery on the same side. (convex side).

3. Surgical steps to correct scoliosis

3.1. Examination of records Perform a full inspection in accordance with the regulations of the Ministry of Health
3.2. Checking the patient The right person (name, age, address...), the right disease
3.3. Implementation of the technique The patient lies in the prone position towards the top of the curve, Carlen is anesthetized with endotracheal anesthesia; Determine the curve of the spine below the 2 plane C-arm to proceed with the placement of the trocar system; Cut the skin about 1.5 cm at the respective intercostal spaces to enter the discs at the top of the scoliosis and around the scoliosis from 2 to 3 levels above and below the scoliosis crest; Use a knife to cut the disc capsule on the side; Use the pince to remove the disc to remove the intervertebral disc nucleus; Use special tools to remove discs and endplates; Grafting, placing allogeneic bone, artificial bone or autologous bone into the position of the disc space just removed; Place the screw brace system on the oriented thoracic vertebrae; Place the brace system along the back spine; Orthopedic spine on screw and brace system; Place a chest drain.

4. Complications and management after scoliosis surgery

Injury to nerve roots, dura: Treat by patching the dura. Injury to the thoracic aorta or vena cava: treatment depends on the location. Surgical wound infection: intravenous antibiotics are used according to the antibiotic chart, and the wound dressing is changed according to the indications; IV fluids, surgery can be done when needed and at the same time, clean up the wound. Pleural blood clot: perform endoscopy to collect blood clot. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space.

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