Dr. Rahul Temani

Spinal Deformity Correction

A spinal deformity is the abnormal bending or rotation of the spine in one or more directions. The spine normally has two gentle curves when observed from the side and appears to be straight when observed from the front. Exaggeration of these normal spinal curvatures can lead to spinal deformities which need to be corrected by surgical means. Spinal deformities may be caused by various conditions including: kyphosis, scoliosis, lordosis and fractures.

Types of spinal deformities

Kyphosis is a spinal deformity which causes excessive rounding of the upper back, typically appearing as a hunchback.
Scoliosis is the abnormal sideways curvature of the spine resembling an ‘S’ curve or ‘C’ curve.
Lordosis is a condition causing excessive inward curvature of the spine.

Based on the type of condition, spinal deformities can cause symptoms such as back pain, fatigue, stooping, spinal instability, and serious issues such as compression of the heart and lungs, causing breathing difficulties.

Indications of Deformity Correction and Stabilization

The following may be some considerations of deformity correction and stabilization procedures:

Spinal deformities with progressive symptoms interfering with organ function.
Kyphosis of 70 degrees or more
Scoliosis of 45 degrees or more
Deformities causing compression of spinal cord and nerve roots
Deformities of highly progressive magnitudes
Deformities resulting from fractures, generally caused by osteoporosis.

Deformity Correction and Stabilization procedure

The main goals of correction and stabilization surgeries include: reduction of pain, restoration of ability to stand erect, relieving pressure on organs (heart and lungs) and preventing progression of the deformity. Different surgical approaches are used based on the type of deformity, location of the curvature and severity of deformity and symptoms. They include:

Anterior approach: The surgeon approaches the spinal column from the front region of the spine through an incision on the chest-wall.
Posterior approach: The surgeon approaches the spinal column through an incision on the mid portion of the back.
Anterior and posterior approach: The surgeon approaches the spinal column through a combination of both anterior and posterior approaches.
Video-assisted thoracoscopic surgery (VATS): A minimally invasive surgical technique which uses a thin, flexible tube with a small camera to gain access to the spine through incisions in the chest.

Each surgical procedure has two main components: Correction of the deformity and stabilization of the spine in the corrected position. The surgery is performed under general anesthesia which includes removal of required amount of bone followed by spinopelvic fixation. Screws, rods, plates, cages etc. are used to hold the spine in the aligned position while healing. Bone graft may also be placed to facilitate fusion of bones for stability.