How Is Scoliosis Surgery Performed?

Scoliosis is an orthopedic condition characterized by a three-dimensional curvature of the spine and is particularly common during childhood and adolescence. While mild cases can generally be managed with monitoring and brace treatment, surgical treatment may become unavoidable in advanced curvatures. Scoliosis surgery is a comprehensive surgical procedure performed to correct the spine, stop the progression of the curvature, and improve the patient’s quality of life.

What Is Scoliosis and Why Is Surgery Necessary?

Scoliosis is a complex deformity that occurs when the spine curves sideways and simultaneously rotates around its own axis. While a healthy spine appears straight when viewed from behind, individuals with scoliosis have “S” or “C”-shaped curvatures. This condition is not only an aesthetic problem but can also lead to serious health problems in advanced cases.

Surgical treatment is generally recommended in the following situations:

If the Curvature Angle Is High: The degree of curvature in the spine is measured using the Cobb angle. If this angle is above 40–50 degrees, surgical treatment may be considered.

If the Curvature Is Progressing: Surgery may be necessary if the curvature is rapidly increasing in children who are still growing.

If Respiratory and Heart Functions Are Affected: Severe scoliosis can narrow the rib cage and reduce lung capacity.

If Cosmetic Concerns Are Significant: Appearance-related problems such as shoulder and hip asymmetry and a prominent spinal deformity may lead to psychological concerns.

At this point, evaluation by an experienced specialist is critically important. Known for his work in scoliosis surgery, Prof. Dr. Ömür Günaldı emphasizes that proper timing and the selection of an appropriate technique for each individual patient are key factors in achieving successful outcomes.

Preoperative Preparation Process

Before scoliosis surgery is planned, a detailed evaluation is performed. This process is extremely important for the success and safety of the surgery.

Imaging Methods

• The degree of curvature is measured with X-rays

• The spinal cord and soft tissues are examined with MRI

• A CT scan is performed if necessary

General Health Assessment

• Blood tests are performed

• Heart and lung functions are evaluated

• Suitability for anesthesia is assessed

Patient and Family Information

The patient is informed in detail about how the surgery will be performed, its risks, and the recovery process. At this stage, realistic expectations regarding the procedure are established.

How Is Scoliosis Surgery Performed?

Scoliosis surgery is generally performed using a method called “posterior spinal fusion.” This procedure involves accessing the spine from the back, correcting the curvature, and stabilizing the vertebrae.

Anesthesia and Positioning: The surgery is performed under general anesthesia. The patient is placed face down on the operating table. This position allows the surgeon to access the spine comfortably.

Making the Surgical Incision: The surgeon makes an incision along the midline of the back to reach the spine. The muscles are carefully separated to expose the spinal bones.

Placement of the Screws: Pedicle screws are placed into the vertebrae. These screws allow the metal rods that will be used to correct the spine to be securely fixed.

Placement of the Metal Rods: After the screws are positioned, metal rods are attached to them. The surgeon uses these rods to gradually correct the alignment of the spine.

Spinal Correction Procedure: The curvature of the spine is corrected in a controlled manner. Extreme care is taken during this stage to avoid injury to the spinal cord. Neuromonitoring is used during the operation to continuously monitor nerve functions.

Fusion Procedure: Bone graft material is used to permanently stabilize the vertebrae. Over time, this graft forms new bone and allows the vertebrae to fuse together.

After the procedure is completed, the incision is closed and the patient is awakened.

Duration and Characteristics of the Surgery

Scoliosis surgery generally takes between 4 and 8 hours. The duration may vary depending on the degree of curvature and the extent of the surgery.

During the surgery:

• Blood loss is controlled

• The nervous system is continuously monitored

• Sterility is maintained at the highest level

Postoperative Process

The postoperative period is critically important for ensuring a healthy recovery.

Intensive Care Period: After surgery, the patient is generally monitored in the intensive care unit for 1–2 days. During this period, pain control is provided and vital functions are monitored.

Ward Follow-Up: The patient is then transferred to the ward. Sitting and walking are gradually initiated. Physical activity is increased in a controlled manner.

Discharge: Patients are generally discharged within 4–7 days. The patient is given detailed information about the precautions that should be followed at home.

Recovery Process

Although the recovery process varies from person to person, it generally progresses as follows:

First Weeks

• Pain control is provided

• Daily activities are limited

• Sudden movements are avoided

First Months

• Light activities are started

• The patient returns to school or work

• Physical therapy may be recommended

Long Term

• The spine fully fuses

• The patient returns to normal daily life

• Sports activities are gradually resumed

Risks and Complications

As with every surgical procedure, scoliosis surgery involves certain risks:

Infection: An infection may develop in the surgical area, but it can be managed with appropriate antibiotic treatment.

Bleeding: Blood loss may occur during or after the surgery.

Nerve Damage: Although rare, there is a risk of nerve damage. Neuromonitoring helps reduce this risk.

Implant Problems: Conditions such as loosening or breakage of the screws may rarely occur.

Modern Approaches in Scoliosis Surgery

Today, technological developments have made scoliosis surgery safer.

Robotic Surgery: Provides more precise screw placement.

3D Imaging: Helps the surgeon plan the operation more effectively.

Neuromonitoring: The nervous system is continuously monitored, helping to reduce risks.

Thanks to these developments, the success rates of surgery have increased considerably.

Psychological Effects

Scoliosis, particularly in young patients, may lead to self-confidence problems. Improvement in appearance after surgery can also help patients feel more comfortable psychologically.

Scoliosis surgery is an effective and reliable treatment method for advanced spinal curvatures. Successful outcomes can be achieved through proper patient selection, an appropriate surgical technique, and an experienced team. Evaluation by a specialist physician is of great importance throughout this process.

One of the experienced specialists in scoliosis surgery, Prof. Dr. Ömür Günaldı, makes significant contributions to this field through his patient-centered approach and modern surgical techniques. Access to accurate information and specialist support during the treatment process helps patients experience a healthy recovery both physically and psychologically.