|
|
|
« Back
I have a type of scoliosis that was severe enough to have surgery when I was a kid. Now my daughter has the same thing. When I had surgery, they used Harrington rods. The surgeon showed us how she would use screws instead of rods for my daughter's correction. It seems like those long rods would work better than the little screws they showed us. Will this really hold her?
|
|
The surgical treatment of large spinal (scoliosis) curves in children has evolved over the past four decades. In the 1960s, the Harrington rods were very popular. They were used to distract or separate the vertebral bodies, put them in good alignment, and hold them there while the child or teen grew. But a better way was found to correct the spinal curve in all three planes (3-D correction) and that was with segmental wires and hooks. Instead of a long rod holding the spine in place, these smaller components linked several segments together. Hooks proved to be safe, easy to place, and effective.
In the last 10 years, the surgical correction of scoliosis has taken another turn. Now pedicle screws are used to achieve fusion in all three planes and improve correction of spinal deformity in children with adolescent idiopathic scoliosis. This type of spinal curvature occurs in older children and teens with no known cause. That's what idiopathic means (unknown).
Pedicle screws are placed posteriorly (from the back of the spine) into a column of bone called the pedicle. The pedicle connects the body of the vertebra to the vertebral arch or ring behind the vertebral body. The vertebral arch goes around the spinal cord to protect it, leaving an opening called the spinal canal for the spinal cord to travel from the brain down to the bottom of the spine.
Despite some concerns about the safety of pedicle screws, they have been found to be completely safe as well as effective in correcting spinal deformity and maintaining that correction. Surgeons have found that it is possible to get better correction in all three planes of spinal deformity by using pedicle screw fixation. Studies show the screws are stronger than hooks and better able to resist being pulled out of the bone (again when compared with hooks). The procedure can be done without an anterior (from the front of the spine) incision, which was required with rod placement. That feature alone is very helpful in reducing the risk of complications (e.g., damage to nerves and major blood vessels).
Best of all, patients can get up sooner and have fewer complications like nonunion or fusion failures. There is also evidence that lung function improves with pedicle screw correction. There is a hope that with all these benefits, the child/teen will not need further (revision) surgery or develop degeneration of the vertebrae above and below the fusion where there is more motion.
Long-term studies have not been completed yet to show the outcomes over time using pedicle screw fixation. But early and midterm studies have shown very positive results even for children with severe deformity.
|
References:
|
|
|
« Back
|
|
|
|
*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
 | All content provided by eORTHOPOD® is a registered trademark of Mosaic Medical Group, L.L.C.. Content is the sole property of Mosaic Medical Group, LLC and used herein by permission. |
|
