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It is normal for parents to be caught off guard when their child gets diagnosed with Scoliosis. When the spine tends to curve sideways, it is known as Scoliosis. Adolescent idiopathic scoliosis is the most common form which occurs among children (10-18 years of age) with more prevalence in girls. The female-to-male ratio ranges from 1.5:1 to 3:1.
AIS accounts for approximately 90% of cases of idiopathic scoliosis in children. This condition can worsen with age and may lead to unsightly distortion of the rib cage, trunk, and shoulders, chronic back pain, and respiratory and cardiovascular problems, and all this is sure to affect the quality of life. Fortunately, several treatment options are available to manage AIS, including surgery.
Treatment Guidelines for Adolescent Idiopathic Scoliosis (AIS):
Two factors determine the scoliosis treatment modality that’s best suitable for your child.
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The severity of the spinal curvature.
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The physical maturity of the child.
The treatment options for the correction of Adolescent idiopathic scoliosis (AIS) are as follows:
Observation
Mild curvature of around 10-25° is when Scoliosis of this type is usually diagnosed, and the doctor will put your child under observation. That means the child will be seen regularly by a spine surgeon to check the curve's progression. In most cases, the curvature doesn't progress and in that case, no treatment is required.
Bracing
Bracing can be useful in patients with moderate curvature between 25-40°. Bracing turns out to be successful if it is begun before the 2nd growth spurt is complete when they grow in height and reach puberty. Thus, early diagnosis of the problem in your child and strict adherence to bracing can avoid surgical intervention. The surgeon may also recommend scoliosis-specific physical therapy before bracing or along with bracing.
Surgical Intervention for Adolescent Idiopathic Scoliosis
Surgery becomes the best treatment option which aims to correct the curvature of the spine. Scoliosis correction surgery is recommended if your child's curve is greater than 45 to 50 degrees or the non-surgical treatments like bracing have failed to prevent the curve from reaching this point. If the curvature of such an extent is left untreated, it may worsen the child's condition to the extent that the lungs become less functional which may lead to respiratory failure.
The surgical approach that is followed to treat this condition is called Spinal Fusion. If you choose minimally invasive robotic fusion, the recovery time will be faster along with reduced pain and scars, offering greater precision in positioning the screws and rods. Manipal Hospital Old Airport Road, Bangalore is the 1st corporate hospital in India, 1st hospital in South India and Karnataka to introduce Medtronic Mazor X Stealth Edition Spine Robotics and O-arm guidance under the radiolucent table for all spine surgeries.
Adolescent idiopathic Scoliosis (AIS) Surgery/Spinal Fusion
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Before the surgery, your child will undergo several tests to check the overall health status and determine the severity of scoliosis. The test includes X-rays, MRIs, and CT scans.
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The procedure is performed under general anaesthesia and takes hours to complete.
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The surgeon must make incisions in the back and use special tools to insert metal rods and screws into the spine.
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In this surgery, the spinal bones are realigned which are responsible for the curvature. Followed by the placement of small bony grafts in between the spaces of these realigned vertebrae. This is done so that the vertebrae are fused and healed into a single bone. The fusion of these bony grafts to vertebrae is similar to healing a broken bone.
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Metal rods are used to hold the bones in a realignment position. These metal rods are attached to the spine by screws, hooks, and wires.
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These metal rods will assist in keeping the spine in straight alignment with the help of screws. Bone removal, if required for the correction, may also be done in some cases.
Post-surgery, the patient is monitored in the hospital for a couple of days to avoid complications.
Robotics in the Surgical Approach of Scoliosis
Surgery for adolescent idiopathic scoliosis is a safe and effective treatment option for patients with severe scoliosis. It’s highly recommended to seek an appointment with a spine specialist to discuss the treatment options for your child’s better future. Recent advancements in adolescent idiopathic scoliosis surgical intervention have improved accuracy and patient outcomes. Robotic guidance systems, coupled with intraoperative O-arm and 3-D imaging techniques are now being used in scoliosis surgery.
Previously, surgeons used to navigate the insertion of screws and rods during scoliosis surgery manually. However, this method was not always accurate and could lead to errors. Robotic assistance now allows surgeons to plan and perform surgeries and position the screws and rods more precisely, minimizing the risk of errors. These systems also reduce the risk of tissue trauma and pain and allow patients to recover more quickly.
Manipal Hospital Old Airport Road will soon be the first corporate hospital in India to offer robotic guidance for scoliosis surgery. This will provide high-risk patients with access to the latest and most advanced treatment options. Book an appointment with the best spine surgeon in Bangalore at Manipal Hospital Old Airport Road if you have any spine problems.
FAQs
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What are the signs and symptoms of Adolescent Idiopathic Scoliosis?
Adolescent idiopathic scoliosis (AIS) does not always develop symptoms other than apparent spine bending. Some patients with AIS may have back discomfort or stiffness, unequal shoulder blades or waist, or abnormalities in gait.
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Can AIS be avoided?
There is no known mechanism to prevent the development of AIS. Early discovery and medical care can assist in keeping the problem from deteriorating and causing issues later in life.
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Does Adolescent Idiopathic Scoliosis always necessitate surgery?
Surgery is considered the last resort in patients with adolescent idiopathic scoliosis. In the early stages, bracing or physical therapy can help manage the disease. Surgery is usually reserved for more severe cases of AIS or when other therapies have failed.
