Anterior Approach
The anterior surgery is the approach done from the side of the chest, hence the name, because it is more to the front. This approach allows for more correction and stability for curves that might have some twisting. However, anterior surgery often requires collapsing the lung and a chest tube to drain fluid. From the people I know who have had the anterior surgery, their time in the hospital is equal to or less than most patients who had the posterior surgery. Once again, each surgery depends on the patient. The choice of procedures is often limited, and, therefore, should be discussed with your child's physician.
Posterior Approach
The posterior surgery is the most common surgery for the common scolosis. This procedure involves making the insision down the back along the spine. Instrumetation is done on one or both sides of the spine to make a good strong hold for the fussion to take place. Usually, a chest tube is not needed. The recovery time is on average a little longer due to where the insision was made. Once again, each surgery depends on the patient. The choice of procedures is often limited, and, therefore, should be discussed with your child's physician.
Anterior Release/Throascopic Release Approach
This is a new innovative proceudre to treat scoliosis that is fastly spreading worldwide. This technique uses a camera to guide the surgeon through a few insisons on the side of the chest cavity. This procedure allows for a much more reduced overall recovery period. Instrumentation is still placed, but the key is that it is much less invasive. The fussion is still done, just as in the other two procedures. A chest tube is also required for this procedure due to the colapsing of the lung. Another diffrence is in that the discs of the back are removed to achive the best possible result. One thing to remember about this procedure is that it is not possible for some soliotics due to how their curve is. Namly, the procedure is only practicle for a minimal throracic curve (i.e. ~40 degrees). Another thing is that not all doctors do this procedure. If you have questions about this, make sure to ask your child's doctor. Also, if you have more questions, see our surgery page, or visit the page of one of the patients, Emily Fritts.
Fussion Facts
Most of these procedures, if not all, involve some form of fussion. This means that the vertebrae are put as one bone so that the curve does not progress. This is accomplished various ways. The most common way is using your child's own bone from his/her hip or rib. The bone is grinded or shaved off and is then sprinkled on the spine. Another way is to use cadaver bone from the bone bank. The bone is grinded much like the bone that might come off the child, and is also just sprinkled on the spine. Finally, some doctors are begining to use new synthetic products that allow the fussion without a removing your child's own bone or using cadaver bone. Your child's physician can tell you what his/her preference is and can choose what is best for your child.
Blood Donation
Scoliosis surgery does often take a lot of blood. Therefore, your child's doctor might require your child and possibly yourself (if you are a blood match) to donate blood. This can be anywhere from 2 units to more. Your child's doctor will tell you of how much you will need. The doctor's office will also let you know what the procedure to do this "self dontation" process in your area if you are unsure.
The procedure for doing the blood donation is rather simple. Your child will have his/her blood pressure checked, pulse and breathing rate checked, and an iron check from a finger or ear prick. If all is ok, he/she will be sat back and will have a blood pressure cuff wraped around his/her arm. It is pumped up to act as a turniquate. When the vein in his/her arm right at the elbow is found, the skin is cleaned with betadyne, a sterilization chemical. Next, a needle conneced to the bag to collect the blood is inserted. This is then taped down and then gravity allows the blood to fill the bag. When all is done, the blood is put in a few test tubes for testing, and then the needle is pulled out. A bandage is placed over the vein, and your child is almost done. He/she will be required to have some food and drink to help replenish any energy that might have been lost through the blood loss. When he/she feels ready and strong enough to leave, then you may go.
In some hospitals, a special machine called a "cell saver" minght be avalible. If so, the doctor might require much less blood or sometimes not at all. The machine takes blood that is suctioned out by the surgical staff, reprocess it so it is more viable, and is pumped back into the patient's blood supply. You might wish to check with your child's physician if this is a concern.
There are always some difrent circumstances, so always check with your child's doctor if you have any questions.
