Scoliosis Surgery in India
Scoliosis is a medical condition in which the spine or backbone abnormally curves on the sideways. “Kyphosis” is the term for the curve which can be seen in the spine when the spine is bent forward. The curve in which the spine is bent backwards that is called as “Lordosis”. The people who suffer with scoliosis disorder develop defective curve in the either side of the spine and the bones of the spine forms a twist which gives a C or S- shaped scoliosis curve.
Some of the known causes of scoliosis have been identified as muscular dystrophy and cerebral palsy whereas in many cases the cause of scoliosis is still unknown. It has also been discovered that Scoliosis is more common in girls than in boys, it affects about 2% of females whereas only 0.5% of males. In most of the cases it has been noticed that scoliosis is not that severe and remains mild throughout the life but in few cases the scoliosis becomes more severe with time. As the spinal curve increases, the amount of space in the chest starts decreasing causing disability in the proper functionality of lungs.
Specific terms for every Scoliosis are -
- Kyphoscoliosis : A combination of outward and lateral spine curvature.
- Dextroscoliosis : Curvature of the spine to the right.
- Rotoscoliosis (rotatory) : Curvature of the vertebral column turned on its axis.
- Levoconvex : Curvature of the spine to the left.
- Thoracolumbar : Curvature related to both the thoracic and lumbar regions of the spine.
Symptoms of Lumbar Scoliosis?
Some of the most common sign s and symptoms of lumbar scoliosis are -
One shoulder blade that is more prominently visible than the other.
One hip visibly higher than the other.
In a severe case of scoliosis the spine can even twist or rotate, making a curve from side to side. This situation causes defect in the position of the rib making it stand out farther from the other side.
Types of Scoliosis
There are different types of Scoliosis that can affect a person but the three main types of Scoliosis and its cause are –
- Functional – In functional type of Scoliosis, there is no direct problem with the spine. The reason of the curve originates from other part of the body such as one leg that is shorter than the other. Also carrying heavy loads or unequal weight lifting can cause curve in the spine.
- Neuromuscular – In this type of Scoliosis, the problem remains right from the beginning when the bones are formed in the body. Either the bones do not form completely or they get entangled during fetal development. This type of scoliosis is formed in people who have other disorders as well such as Marfan syndrome, muscular dystrophy, birth defects and cerebral palsy.
- Degenerative Scoliosis – Unlike the other two types of scoliosis that are associated with children, this one is related to adults and older people. It is caused due to the condition known as spondylosis which is a type of arthritis. When the surrounding ligaments and tissues of the spine start to weaken combined with sudden bone development that can lead to abnormal curve in the spine. In this case the curve can also generate due to vertebral compression fractures, osteoporosis and disc degeneration.
Methods to Diagnose Scoliosis
Usually a thorough physical examination is conducted to diagnose a Scoliosis. A positive Scoliosis is diagnosed based on a coronal curvature that is measured on a posterior anterior radiography that is greater than 10 degrees. If the curve is diagnosed to be greater than 25 to 30 degrees then it is considered to be significant. If it exceeds 45 to 50 degrees then it is a severe situation and requires instant treatment.
Physical examination used to diagnose Scoliosis are -
- X-ray – In X-ray, radiation is projected on the specific part of the body to produce picture of the vertebrae and the outlines of the joints. It can further diagnose other potential causes of pain and curve such as fractures, deformities, infections, etc.
- Computed tomography scan (CT or CAT scan) – It is useful in forming a good picture of the bony structures. It can show the exact shape and size of the spinal cord and spinal canal.
- Magnetic Resonance Imaging (MRI) – This test generates a three-dimensional image of the body with the help of magnetic and computer technology. It clearly shows the spinal cord, nerve roots and other surrounding areas.
Treatment of Scoliosis
Once when it gets confirmed through diagnosis that the person is suffering with scoliosis, the next step is to determine the treatment options which is based on following points –
Spinal Maturity – If the patients spine still growing.
Degree and extent of curve – It is to specify how severe is the curve and how it is affecting the patient.
Location of curve – It has been observed that the thoracic curves are more likely to increase than the curves developed in other regions of the spine.
Curve progression – Patients who have developed significant curves before the adolescence are more likely to experience curve progression.
Once these factors are assessed the treatments are recommended. The types of treatment for Scoliosis are –
In most of the cases the spinal curves are not that severe to require a specific treatment. But in some cases the doctor is worried about the further growth of the curve and might want to observe the child in a four to six months span.
The patients who have yet not reached the skeletal maturity can be treated with the option of braces. If the child is still in the growing age and the curve bend is between 25 degrees to 40 degrees then the braces are most likely recommended. Braces that are used with full compliance have shown a successful stop of curve progression in about 80% of children.
When the surgery is conducted in children, the main motto is to stop the progression of curve and to eradicate the spinal deformity. The surgery is basically recommended when the spinal curve is more than 40 degrees. The surgery can be done in two ways either using an anterior approach that is through the front or the posterior approach which is done from the back.
The adults who have received a spine correction surgery as children might have to undergo a revision surgery after 20 or 30 years.
When the surgery is conducted in adults the criteria is to have a curve that is greater than 50 degrees accompanied with nerve damage in the legs or some sort of bowel/bladder syndrome.
Adults suffering with degenerative scoliosis and spinal stenosis are treated with decompression surgery in which the spines are fused together and the surgery is conducted from both the anterior as well as posterior approach.
Some of the factors that can lead to surgical risks in older adults are- old age, being overweight, too much smoking and the presence of some other health problems.
Cost of Scoliosis Surgery in India
In India the overall Scoliosis treatment and surgery can be found at best rates. The estimated cost of Scoliosis surgery in India ranges in between USD 11000 to USD 13000. Rest the variation in rate also depends on the choice of hospital, treatment and other facilities.
Recovery time -
The duration of surgery and the recovery time, both are expected to be more in the adults with scoliosis than the children who are suffering with scoliosis. The total days of stay in the hospital ranges between 5 days to one week whereas outside the hospital it takes around 21 days for recovery.