Surgery for Scoliosis
New York City’s Scoliosis Surgery
When surgery is necessary for scoliosis, of Och Spine at NewYork-Presbyterian at the Weill Cornell Medicine Center for Comprehensive Spine Care takes the least invasive approach possible. The goal of surgery is to straighten the curve, halt its progression, fuse the spine, and insert implants. The surgeon will choose specific surgical procedures for the patient depending on the details of the diagnosis. Our spine surgeons have developed expertise in some of the most technically advanced surgery for scoliosis:
Minimally Invasive Lumbar Fusion
This surgery fuses the bones of the spine in the lower back together so that there is no longer any motion between them. This reduces spinal pressure, pain, and nerve damage and fixes the deformity. Minimally invasive lumbar fusions do not require the large incision or the muscle retraction typically used in conventional fusions. Patients undergoing this procedure have a fast recovery time. A recent advance is the use of a computerized image guidance system for many patients undergoing lumbar fusion. This has the advantage of aiding the surgeon in optimal placement of screws and avoiding injury to delicate nerve tissue.
Until recently, all patients undergoing lumbar fusion required a bone graft either from the hip region or from a bone bank. Currently, many patients are candidates for BMP, a synthetic protein which encourages bone growth. One major advantage of the BMP is that it eliminates the need for a second operative site for bone grafting. In most patients undergoing lumbar spinal fusion, metal titanium instrumentation is also used. This will typically involve placing pedicle screws into the bone and connecting these with a rod.
Posterior Cervical Laminectomy
Laminectomy is surgical procedure used to treat severe cases of cervical scoliosis. Surgery is performed under general anesthesia, and the pressure of the spine is decreased by removing the portion of the vertebrae that is compressing the spine and nerve structures. Bone grafts are inserted into the spine and held in place by rods and screws, which stabilizes the neck and creates a fusion of the vertebrae. Over time, as the neck heals, new bone grows around the screws and fuse the spine. Patients usually wear a hard, cervical collar for 6 weeks after surgery.
In the XLIF procedure, a neurosurgeon approaches the spine from the side and inserts a spacer to correct curvature.
XLIF (Extreme Lateral Interbody Fusion)
This advanced method of minimally invasive surgery approaches the spine from the side, avoiding the major muscles of the back. A spine surgeon makes a small incision in the patient’s side, between the lower ribs and pelvis, and inserts a special surgical instrument just above the disc space. The surgeon removes the damaged disc tissue and inserts a spacer between the vertebrae. The surgical team monitors the position and correct placement of the spacer, sometimes using special screws or a plate on the side of the spine to offer additional stability.
Patients typically are walking within a few hours of the XLIF procedure and are then discharged the next day. Most patients are back to work within approximately two weeks.
In the X STOP procedure, a spacer inserted in a minimally invasive procedure corrects the curvature of the spine.
X STOP Procedure
The X STOP is a new FDA-approved device for the treatment of lumbar scoliosis. The X STOP device is a titanium spacer that can be inserted between the spine and ligaments and tendons as an alternative to laminectomy and/or fusion. Unlike a laminectomy, no bone removal is required. Generally placement of the X STOP can be performed under local anesthesia in under one hour. Many patients are up and walking that same day.
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For more information about our treatment options, contact our office today.