Surgery Expectations

We see more than 3,000 scoliosis patients each year, but surgical patients make up only 3 percent of our total scoliosis visits. When a child with scoliosis does need surgery, that's when experience, options and family support matter. Orthopedic surgeons at Children's Wisconsin use the most advanced techniques in scoliosis surgery, including procedures that dramatically reduce recovery time from months to days.

Surgical treatment is sometimes needed when the curve has progressed past 45-50 degrees. The purpose is to keep the scoliosis from continuing to get bigger. If left untreated, very large curves can cause health problems later in life to the heart, lungs, and to the spine itself. While the surgery is not usually urgent, waiting too long to treat it may make the spine harder to correct and could lead to a riskier surgery.

At Children's, we have a number of unique things in place to provide the best and safest care. Proud to be a Level I children's surgery center:

• TEAM STEPPS Team Strategies & Tools to Enhance Performance & Patient Safety. This is an evidence-based initiative – drawing upon more than 25 years of research in the military, aviation, nuclear power, and business industries – that we use within our surgical orthopedic services to improve patient safety and outcomes, along with making the patient experience better overall.
• O-arm: The O-arm Surgical Imaging System is a specialized surgical imaging tool that provides 2D and 3D pictures that is designed for use in spine, orthopedic, and trauma-related surgeries. It provides real-time, intra-operative imaging of a patient's anatomy with high-quality images and a large field-of-view in both two and three dimensions.
• Patient Journey: The Patient Journey messaging service sends you timely information and reminders when you need them the most. Based on your child's upcoming spine procedure, updates sent directly to your mobile phone include information on what to expect, how to prepare, how the procedure is going, and important steps to take and things to know in the days and weeks following.

Types of surgeries

Spinal surgery: Surgery is recommended for patients whose curves are greater than 45-50 degrees. Fusion surgery today uses metal implants attached to the spine to hold the spine in place which will allow the spine to fuse and prevent the scoliosis from getting bigger. Most surgeries today are a posterior approach in which an incision is made on the back.

Post-surgery recovery:

• 3-6 days: Surgery and in the hospital
• 10-14 days: Recovery at home requiring care and pain medications
• 3-6 weeks: Patient return regular daily activities and typically returns to school
• 3-6 months: Depending on the patient's activities, full participation is allowed.

Growing technology for early onset scoliosis

• MAGEC – These metal rods are surgically inserted, but then can be adjusted by magnets as your child grows. This negates the need for surgery during follow-up adjustments. Read about a recent Children's patient who received MAGEC rods.
• CASTING – In cases of infantile idiopathic scoliosis, casting can sometimes be effective. Children's has specialists who are trained in EDF (elongation, derogation, flexion), a casting technique that can allow patients to avoid spinal surgery and in some cases improve the scoliosis. For more information, infantilescoliosis.org as a further resource.
• VEPTR (Vertical Expandable Prosthetic Titanium Rib) – This curved, metal rod helps separate your child's ribs as it straightens their spine to allow the lungs to expand as they grow. It is surgically attached to your child's ribs, spine, or pelvis with hooks on both ends. Its length can be adjusted as your child grows.