General information
During surgery to treat scoliosis, metallic screw-rod systems are inserted for correction. This system can be mounted either from the front (ventral) or from the back (dorsal). After the spinal column curvature has been corrected, the surgically treated spinal column section must be stiffened. This ensures a lifelong correction, but the mobility in the affected spinal section is eliminated.
Preparation
If a scoliosis is detected early and treated according to its stage, often no spine-stretching procedure is necessary. However, in cases of very severe or stiff scoliosis, or if the spine is curved forward (hyperkyphosis), it may be necessary to stretch the spine before surgery. This is done in the so-called traction procedure (lat.
tractio= traction, traction force). A ring fixed to the head exerts a permanent longitudinal traction on the spinal column, resulting in stretching of the trunk. This method is intended to slowly stretch the curvature and the shortened soft tissues (muscles and ligaments). This serves a better and neurologically safe surgical result.
Access route
Whether surgery is performed from the front (ventral) or the back (dorsal) depends on the location of the scoliosis. In most operations, however, one surgical access is sufficient for the entire operation. In some cases, the patient must be repositioned during the operation to reach both access routes.
Surgical technique – rear access route
The patient is positioned on his stomach and first the spinous processes of the vertebral bodies are exposed. Then screws are anchored in the vertebrae on both sides via the arch roots (so-called pedicle screws). After these screws have been used to insert the rods into the spinal column, the curvature can be corrected.
When the spine is straight again at the corresponding point, bone or bone replacement material is inserted between the operated vertebral bodies. As a result, the operated vertebrae grow together, so that a new curvature is not possible. In the first year after the operation, the screw-rod system inserted serves to stabilize the correct position of the spinal column. Within this year, the bony vertebral bodies grow together, so that theoretically the inserted material can be removed again afterwards. In most cases, however, this is not advisable due to the large number of repeat operations.