What are Correction of Curved Spine

Correction of curved spine, also known as spinal deformity correction surgery, is a complex procedure aimed at realigning the vertebral column to improve spinal alignment, stability, and function. Spinal curvature abnormalities can result from various underlying conditions, including scoliosis, kyphosis, and lordosis. Surgical correction of curved spine involves the use of specialized instrumentation, bone grafting techniques, and intraoperative navigation to achieve optimal spinal alignment and restore physiological curvature. Understanding the indications, surgical techniques, risks, and benefits associated with correction of curved spine is essential for orthopedic surgeons, spine specialists, and patients affected by spinal deformities.

Procedures
Correction of curved spine involves a series of surgical steps aimed at realigning the vertebral column and stabilizing the spine. Here is an overview of the typical procedure involved in correction of curved spine:
  1. Preoperative evaluation: Before the surgery, the patient undergoes a comprehensive preoperative assessment, including medical history review, physical examination, neurological evaluation, and imaging studies (such as X-rays, CT scans, or MRI scans) to assess the severity and characteristics of the spinal deformity. The indication for surgical correction, surgical approach, and potential risks are discussed with the patient and family members.
  2. Anesthesia administration: Anesthesia is administered to ensure the patient remains comfortable and immobile during the surgery. General anesthesia is typically used for spinal deformity correction surgery to induce unconsciousness and prevent movement during the procedure. Anesthesia providers monitor the patient's vital signs and adjust anesthesia depth as needed.
  3. Patient positioning: The patient is positioned on the operating table in a prone, lateral, or supine position, depending on the type and location of the spinal deformity. Padding and support devices are used to maintain proper spinal alignment and minimize pressure injuries.
  4. Surgical approach: Spinal deformity correction surgery is performed in a sterile operating room environment using aseptic technique and specialized orthopedic instrumentation. The surgical team wears sterile gowns, gloves, masks, and surgical drapes to minimize the risk of surgical site infection.
  5. Exposure of the spine: The surgical site is exposed through a midline or lateral incision, depending on the type and location of the spinal deformity. Soft tissue dissection and muscle retraction techniques are used to access the vertebral column and visualize the spinal anatomy.
  6. Vertebral osteotomy: In cases of rigid spinal deformities or fixed bony abnormalities, vertebral osteotomy or bone resection may be performed to facilitate spinal realignment and correction. Various osteotomy techniques, such as pedicle subtraction osteotomy, vertebral column resection, or Smith-Petersen osteotomy, may be employed depending on the specific characteristics of the deformity.
  7. Instrumentation placement: Specialized spinal instrumentation, such as pedicle screws, rods, hooks, and connectors, are placed along the vertebral column to stabilize the spine and maintain proper spinal alignment. The instrumentation is carefully positioned and secured to the vertebral bodies using screws or hooks inserted into the pedicles.
  8. Bone grafting: Bone graft material, either autograft (patient's own bone) or allograft (donor bone), may be used to promote spinal fusion and enhance spinal stability following deformity correction. The bone graft is placed within the intervertebral spaces or along the posterior elements of the spine to facilitate bony fusion.
  9. Spinal fusion: Spinal fusion involves the creation of a solid bony bridge between adjacent vertebrae, promoting long-term stability and alignment of the spine. Bone graft material, along with biological or synthetic bone graft substitutes, promotes bone healing and fusion across the instrumented segments.
  10. Closure of the surgical site: After spinal deformity correction and spinal fusion are achieved, the surgical incision is closed in layers using absorbable sutures or surgical staples. A sterile dressing or surgical bandage is applied to the wound to promote healing and reduce the risk of infection.
  11. Postoperative care: Following spinal deformity correction surgery, the patient is transferred to the recovery area for close monitoring of vital signs, neurological status, and surgical site integrity. Postoperative imaging studies (such as X-rays or CT scans) may be performed to assess spinal alignment, hardware position, and fusion status.
  12. Pain management: Adequate pain management is essential for optimizing postoperative recovery and patient comfort. Analgesic medications, such as opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or local anesthetics, may be administered to alleviate postoperative pain.
  13. Neurological monitoring: The patient's neurological status, sensory and motor function, and bowel/bladder function are closely monitored in the postoperative period to detect any signs of neurological deficits or complications. Serial neurological examinations and imaging studies may be performed to assess spinal cord function and integrity.
  14. Complication management: Prompt recognition and management of postoperative complications are essential for optimizing patient outcomes and preventing long-term sequelae. Complications such as wound infection, hardware failure, implant malposition, neurological deficits, or pseudarthrosis require timely intervention and close monitoring by the healthcare team.
  15. Rehabilitation and support: Depending on the extent of spinal deformity correction and patient's functional status, rehabilitation services (such as physical therapy, occupational therapy, or bracing) may be recommended to facilitate postoperative recovery, improve mobility, and enhance quality of life. Assistive devices, adaptive equipment, and patient education are provided to promote safe ambulation and activities of daily living.
  16. Long-term follow-up: Regular follow-up appointments with the orthopedic surgeon or spine specialist are scheduled for long-term monitoring of the patient's spinal alignment, fusion status, and functional outcomes. Serial imaging studies (such as X-rays or CT scans) may be performed to assess spinal fusion progression, hardware integrity, and stability over time.
  17. Education and counseling: Patients and families receive comprehensive education and counseling regarding the surgical procedure, expected outcomes, potential complications, and long-term care needs. Information about activity restrictions, wound care, pain management, and rehabilitation goals is provided to facilitate informed decision-making and self-management.
Risk
  1. Neurological deficits: Correction of curved spine carries a risk of neurological deficits due to injury to the spinal cord or nerve roots during surgery. Neurological deficits may manifest as sensory loss, motor weakness, bowel/bladder dysfunction, or gait disturbances postoperatively. The risk of neurological deficits depends on factors such as spinal deformity severity, surgical technique, and patient comorbidities.
  2. Instrumentation failure: Spinal instrumentation used for correction of curved spine may fail due to hardware breakage, loosening, or malposition, leading to loss of spinal alignment or stability. Instrumentation failure may require revision surgery to repair or replace the hardware and restore spinal function.
  3. Implant-related complications: Placement of spinal instrumentation carries a risk of implant-related complications, such as screw pullout, rod fracture, or implant migration. These complications may result from inadequate fixation, poor bone quality, or biomechanical stress on the spinal implants. Revision surgery may be necessary to address implant-related issues and maintain spinal stability.
  4. Pseudarthrosis: Incomplete spinal fusion or pseudarthrosis may occur following correction of curved spine, leading to instability and recurrent deformity. Pseudarthrosis may result from factors such as poor bone quality, inadequate bone grafting, or excessive mechanical stress on the fusion site. Revision surgery with bone grafting and spinal fusion may be required to achieve bony union and restore spinal stability.
  5. Wound complications: Surgical wound complications, such as infection, dehiscence, or seroma formation, may occur following correction of curved spine, particularly in patients with predisposing factors such as obesity, diabetes, or smoking. Proper wound care, antibiotic prophylaxis, and wound surveillance are essential for minimizing wound complications and promoting wound healing.
  6. Adjacent segment degeneration: Correction of curved spine may alter spinal biomechanics and increase stress on adjacent spinal segments, predisposing them to degenerative changes such as disc herniation, facet arthropathy, or spinal stenosis. Adjacent segment degeneration may manifest as new or worsening back pain, radicular symptoms, or spinal instability requiring further intervention.
  7. Blood loss: Correction of curved spine surgery carries a risk of significant intraoperative and postoperative blood loss, particularly in cases of extensive spinal instrumentation and osteotomy procedures. Blood loss may necessitate blood transfusion, hemostatic agents, or intraoperative cell salvage techniques to maintain hemodynamic stability and prevent complications associated with anemia or hypovolemia.
  8. Thromboembolic events: Prolonged operative time, immobility, and surgical manipulation of the spine increase the risk of thromboembolic events such as deep vein thrombosis (DVT) or pulmonary embolism (PE) following correction of curved spine surgery. Mechanical prophylaxis (such as compression stockings or intermittent pneumatic compression devices) and pharmacological prophylaxis (such as anticoagulant medications) are used to mitigate the risk of thromboembolic complications.
  9. Respiratory compromise: Correction of curved spine surgery may result in respiratory compromise or pulmonary complications due to changes in chest wall mechanics, diaphragmatic function, or ventilatory capacity. Patients with preexisting pulmonary conditions, neuromuscular disorders, or obesity are at increased risk of postoperative respiratory complications requiring close monitoring and respiratory support.
  10. Loss of correction: Despite surgical correction of curved spine, loss of spinal alignment or recurrence of deformity may occur over time due to factors such as incomplete fusion, implant failure, or progression of underlying spinal pathology. Regular follow-up evaluations, spinal imaging studies, and patient education are important for detecting and addressing loss of correction early to prevent symptomatic recurrence.
Advantages
  1. Spinal alignment improvement: Correction of curved spine surgery results in improved spinal alignment and posture, reducing deformity and restoring spinal balance. Realignment of the vertebral column improves overall spinal biomechanics, reduces mechanical stress on spinal structures, and alleviates symptoms such as back pain, radiculopathy, and neurogenic claudication.
  2. Pain relief: Correction of curved spine surgery provides significant pain relief for patients with spinal deformities, as it addresses the underlying cause of pain and instability. Restoration of spinal alignment and decompression of neural structures alleviate pressure on nerves, discs, and facet joints, reducing inflammatory cytokine release and nociceptive signaling.
  3. Functional improvement: Correction of curved spine surgery enhances functional capacity and mobility for patients with spinal deformities, enabling them to perform activities of daily living, work, and recreational pursuits more effectively. Improved spinal stability, muscular balance, and range of motion contribute to enhanced functional independence and quality of life.
  4. Prevention of progression: Correction of curved spine surgery prevents the progression of spinal deformities and associated complications, such as respiratory compromise, neurologic deficits, and cardiopulmonary dysfunction. Early intervention and correction of spinal curvature abnormalities mitigate the risk of long-term disability and improve overall prognosis for affected patients.
  5. Cosmetic enhancement: Correction of curved spine surgery improves the cosmetic appearance of the back and trunk, reducing visible deformity and asymmetry. Patients experience increased self-confidence, body image satisfaction, and social acceptance following correction of spinal curvature abnormalities, leading to improved psychosocial well-being and quality of life.
  6. Enhanced respiratory function: Correction of curved spine surgery improves respiratory function and pulmonary mechanics by optimizing chest wall expansion, diaphragmatic excursion, and lung ventilation. Reduction of thoracic curvature abnormalities and restoration of thoracolumbar alignment facilitate more efficient gas exchange, oxygenation, and ventilation-perfusion matching.
  7. Neurological preservation: Correction of curved spine surgery aims to preserve neurological function and prevent neurological deterioration by relieving pressure on spinal cord or nerve roots. Decompression of neural elements and restoration of spinal alignment minimize the risk of neurologic deficits, sensory loss, motor weakness, and bowel/bladder dysfunction.
  8. Bone fusion and stability: Correction of curved spine surgery promotes spinal fusion and stability by creating a solid bony union between adjacent vertebrae. Bone graft material, along with spinal instrumentation, facilitates bony fusion across the corrected spinal segments, preventing implant failure, pseudarthrosis, or loss of correction over time.
  9. Improved quality of life: Correction of curved spine surgery significantly improves the overall quality of life for patients with spinal deformities, as it reduces pain, improves function, and enhances self-esteem and body image. Patients experience fewer physical limitations, greater social participation, and improved emotional well-being following successful correction of spinal curvature abnormalities.
  10. Long-term outcomes: Correction of curved spine surgery provides durable and sustainable results, with long-term maintenance of spinal alignment, stability, and function. Regular follow-up evaluations, spinal imaging studies, and patient education are essential for monitoring spinal health, detecting potential complications, and optimizing long-term outcomes for affected individuals.
Includes
  1. Anaesthesia
Procedure Fee : 69000 75900 (Inclusive of all charges)
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