SCOLIOSIS CENTRE
SCOLIOSIS CENTRE
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  • UMSC Scoliosis Centre
    Our comprehensive team of caregivers offers you the best of scoliosis management to help patients achieve their best functionality while experiencing the least disruption to his or her life during the treatment process
    FAQ

    What is scoliosis?

    A lateral curvature of the spine from side to side forming a “C” or “S”
    shape curve with the Cobb angle of more than 10°

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    Types of Scoliosis

    Idiopathic Other causes
    Infantile (IIS) 0-3 years old Congenital
    Juvenile (JIS) 3-10 years old Syndromic
    Adolescent (AIS) 10 – 18 years old (Most Common) Neuromuscular Disease

    Do I have scoliosis?

    Systoms and signs of idiopathic scoliosis include:

    • – Abnormalcurve of the Spine
    • – Uneven shoulders
    • – Prominent shoulder blade and rib cage, especially when bending forward
    • – Uneven hips
    • – Difference in Leg length
    • – Abnormal walking pattern

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    Treatment Options


    Cobb Angle (X°) Mode of Treatment
    10 – 20° Observation with follow-ups
    20 – 45° Brace
    > 45° Surgery

    Surgical Treatment

    Surgical treatment is reserved for scoliosis curves > 45 degrees

    Aims:

    i) Tp prevent worsening of the curve
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    The figure above shows the progressive worsening of the curve over a year
    in one of our patients who is immature/prepubertal
    (before first menses / period)

    ii) To straighten the spine (correction rate between 50-75%)
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    iii) To prevent deterioration of the lungs and create more abdominal space

    iv) Better cosmesis

    How is the surgery performed?

    Posterior Spinal Fusion
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    Multiple pedicle screws are inserted into the spine from the back and are
    connected by rods to straighten the spine

    The surfaces of the bones are rawed and bone grafts (from patient’s bone)
    are laid on it

    The initial spine stability is provided by screws and rods, but as soos as
    the patient’s bone grows, it would be strong enough to maintain the spine
    in a straight position.

    What are the risks of surgery?

    The overall complication rate (major and minor) is approximately 5%

    The table below describes all the major and minor complications that arose in posterior fusions for AIS as reported by SRS in 2006

    Type Posterior (%) (Number of patients = 4369
    Wound Infection 1.35
    Pulmonary (not pulmonary embolus) 0.96
    Implant related 0.64
    Neurologic 0.32
    Dural Tear 0.18
    Nonfatal bleed 0.14
    Deep Vein Thrombosis 0.05
    Pulmonary embolus 0.02
    Blood loss (fatal) 0.02
    Air embolus (fatal) 0.02

    In our centre, the major complication rate is less than 0.5% (Based on the scoliosis database in University of Malaya)

    What happens if you do not undergo surgery?

    There will be and increased risk of developing a larger curve leading to loss of body balance
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    Generally there are 3 different groups if curve progression:

    Group Outcome
    Immature / prepubertal patients (before 1st menses / period) Curve will progress very aggressively 
    Immature / postpubertal patients (after 1st menses / period) Progression is approximately 5-10 degrees over a year
    Mature (after attaining skeletal maturity) with curve > 50 % Progression is approximately 1 degrees over a year

    When the curve reaches 100 degrees or more, the risk of lung/heart failure is higher; which may lead to death at an earlier age.

    How long will the Operation take?

    Operation will take Approximately 3 hours.

    How would the Patient deal with the Post Operative pain?

    The post operative pain will be controlled using multimodal pain relieve techniques which includes patient controlled analgesia , oral anti inflammatory and analgesic agents and local infiltration of pain relieving medication at the wound site

    When will the patient be able to get up and walk for the first time after surgery?

    Usually within 24 hours

    How many days do the patients stay in the hospital?

    3 – 4 days.

    When can I Return to School?

    You Will be able to return to school in approximately 3 to 4 weeks

    How soon the patient will be able to return to normal activities after surgery?

    3 – 4 months

    Can the patient participate in sports?

    Yes, but preferably no contact sports for the first 12 months.

    For female patients, does scoliosis surgery affect pregnancy in the future?

    NO