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Spinal surgery for children – what’s possible?

In addition to general surgery, private paediatric health care also extends to specialist areas of surgery, including delicate and difficult spinal surgery to correct problems caused by congenital problems or injuries.

 

Can surgery help my child’s scoliosis?

Scoliosis is a pronounced curvature of the spine of more than 10 degrees. It is one of the most common forms of congenital spinal deformity in children and can require spinal surgery.

 

Congenital scoliosis is present from birth while idiopathic scoliosis (often also called structural scoliosis) develops later but its cause is unknown. Curvature of the spine can also be due to neuromuscular changes, such as poor posture or having legs that are slightly different lengths. This is described as non-structural scoliosis to distinguish it from the other two types. In non-structural scoliosis, treating the underlying cause of the problem may be effective without the need for spinal surgery. However, in true, ‘structural’ scoliosis, where there is no obvious cause to treat, spinal surgery is usually recommended.

 

Recognising scoliosis symptoms

Scoliosis is not usually a painful condition, but in severe cases it can distort the overall shape of your child’s body, which is distressing for parents and children. Often, the first ‘symptom’ that you may notice in your child is that their clothes hang unevenly. Their posture may appear to change, with their hip, shoulder blade or ribs sticking out more on one side than the other. In severe cases, scoliosis can affect breathing or cause back pain.

 

If you are worried that your child may have scoliosis, your GP will usually perform a physical examination and ask about the medical history of your child and family members. You may then be referred to an orthopaedic specialist for further tests. These can include an X-ray of the spine, or a CT (computerised tomography) or MRI (magnetic resonance imaging) scan.

 

Treating scoliosis

Spinal surgery for scoliosis may not be necessary if the curvature is mild. Initially, your child may need to wear a brace – a device made of plastic or fibreglass that is worn around the torso for up to 23 hours a day. A brace will only be effective if your child is still growing. It will not correct the problem but it can help to prevent it getting any worse.  The younger your child is when the condition appears, the more severe it is likely to become as they grow so early corrective treatment is always a good idea.

 

In severe cases, a type of spinal surgery called spinal fusion may become necessary. In this operation several vertebrae are fused together and held in place with metal rods to reduce the curvature of the spine and to prevent further changes. Spinal surgery for scoliosis carries some risks, including pain or infection, nerve damage, incomplete fusion of the vertebrae and damage to the metal rods after surgery. Further spinal changes can also happen if your child continues growing after spinal surgery. In these cases repeat spinal surgery could be needed.

 

Why else might my child need spinal surgery?

Other conditions that occur in children and that may need spinal surgery include spondylolysis (a stress fracture in one of the vertebrae), spondylolisthesis (when one vertebra slips over another; this can be congenital or caused by spondylolysis), herniated discs and neural tube defects. Spinal surgery can also be used to treat spinal cord tumours or spinal trauma.