Highlights of the case are:-
- 13 year old girl had increased curvature of her backbone two years back
- No history of any major illness or any trauma. She had normal birth and normal growth
- On examination Spine showed kypho-scoliotic (Rt) sided curve, with prominent rib hump, curve was not balanced and shoulder was not aligned with pelvis.
- Curve was partially correctible on bending on sides and rib hump was pronounced on bending forwards. Her MRI and CT scan was also done to Rule out any associated congenital abnormalities and to assess spinal cord status.
- Curve being 67 degrees and progression of curvature, it was decided to operate on her and posterior corrective surgery was planned
- Doctors performed complex technique for passage of pedicle screws and for scoliosis corrections as it is a permanent solution compared to techniques in which hooks and rods are used.
Problems faced by the parents…After an x-ray at a local hospital in Kuwait, the girl’s parents came to learn that her backbone was growing uncontrollably. Surgery being complicated, they were not able to find any local hospital at Kuwait to treat our daughter’s case.
A valuable suggestion given by a friend to go to India!
The girl’s school mate, who suffered from a similar problem and underwent a successful surgery at Safemedtrip affiliated hospital in India, suggested taking her to India and getting an opinion from the specialists. Seeing her friends progress after surgery and the drastic improvements she had the family decided to come down to India to consult the doctor. A thorough examination by the doctor and his team confirmed a case of Scoliosis.
What is Scoliosis and why is it complicated?
Scoliosis is a curving of the spine. The spine curves away from the middle or sideways. Scoliosis is a condition that can affect the spines of many children, teenagers and adults. Scoliosis is curvature of spine in coronal plane. There are many causes of scoliosis and type of scoliosis is classified accordingly as, congenital, paralytic, and neuro fibromatic. Commonest being adolescent onset idiopathic scoliosis (AIS).
Scoliosis correction is complicated because: –
- Scoliosis surgery requires a lot of planning before surgery. Length of fixation, level of fixation has to be decided before hand. This has to be accurate.
- Scoliosis Surgery is to be done by surgeon who is highly trained & experienced in spine surgery.
- Even though many ways of fixation are used, pedicle screws fixation is scientifically proper way of fixation since it fixes all 3 columns of vertebra and helps in proper correction.
- However pedicle screw fixation is complex surgery since in thoracic spine size of pedicle is small, anatomy is deformed and any Mal placement of screw can cause injury to neurological structures and lung and vessels.
- On examination at the hospital, her Spine showed a kypho-scoliotic (right) sided curve, with a prominent hump. Medically it is termed as Adolescent onset idiopathic scoliosis.
- The Curve was not balanced and shoulder was not aligned with her waist. Curve of the backbone being 67 degrees, it was decided to operate on her and posterior corrective surgery was planned.
- She underwent a successful surgery which lasted for 4 hours.
- The girl required 1 blood transfusion which was given immediate post operatively. She was allowed mobilisation in bed immediate postoperatively, was allowed to sit with backrest from 2nd post op day. Plastic moulded brace was fitted after dressing and drain removal.
- By 4th post op day patient was standing and walking with help from physiotherapist and was independent from 6th post-op day. Post operative x-rays showed good correction and residual curve measured 23 degrees. Due to correction of scoliotic curve, patient gained in height of 2 cm. She is very keen to start her dancing lessons as early as possible.
- Within seven days of surgery the girl was able to walk properly. Doctor asked her to exercise regularly for at least three months.