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Scoliosis Surgery

Scoliosis Surgery. Mark Wilms, CST ST Program Director Anthem College Aurora, Colorado. Scoliosis. An abnormal side to side curvature of the spine. Scoliosis. Develops in the thoracic spine The thoracolumbar area of the spine Only in the lumbar spine. Scoliosis. Causes Congenital

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Scoliosis Surgery

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  1. Scoliosis Surgery Mark Wilms, CST ST Program Director Anthem College Aurora, Colorado

  2. Scoliosis • An abnormal side to side curvature of the spine.

  3. Scoliosis • Develops in the thoracic spine • The thoracolumbar area of the spine • Only in the lumbar spine

  4. Scoliosis Causes • Congenital • Developmental • Degenerative • Idiopathic (most common)

  5. Scoliosis The most common forms of Scoliosis: • Congenital • Neuromuscular • Degenerative • Idiopathic

  6. Scoliosis Congenital

  7. Scoliosis Cerebral Palsy Muscular Dystrophy Neuromuscular

  8. Scoliosis Degenerative

  9. Scoliosis Idiopathic

  10. Scoliosis Idiopathic Scoliosis • Infantile scoliosis birth to 3 years • Juvenile Scoliosis 3 to 9 years • Adolescent scoliosis 10 to 18 years

  11. Facts Scoliosis

  12. Scoliosis Scoliosis testing • Physicians exam • X-ray

  13. Scoliosis Treatment is based on two factors; • Skeletal maturity • Degree of curvature

  14. Scoliosis Treatment • Observation • Back Braces • Surgery

  15. Scoliosis Observation Curvature of the spine • Cobb angle measurement

  16. Scoliosis Braces • Milwaukee brace • Charleston brace • TLSO brace

  17. Scoliosis Bracing results (worn for 18 months, 23 hours a day) Before After

  18. Scoliosis Surgery

  19. Scoliosis Two General Approaches: • Posterior approach • Anterior approach

  20. Scoliosis Posterior Surgical Approach

  21. Scoliosis OSI spine table

  22. Scoliosis Room Preparation

  23. Scoliosis Positioning

  24. Scoliosis Hooks, Wire, Screws, and Rods

  25. Scoliosis Instrumentation

  26. Scoliosis Hooks • Each hook site is prepared using a hook finder or elevator.

  27. Scoliosis • Implants are applied to the spine to correct the deformity. • Hooks are placed in the thoracic spine and screws are generally used in the lumbar spine.

  28. Scoliosis Rod Contouring • The rod is contoured to the desired correction • Additional contouring is done with in situ benders

  29. Scoliosis Rod insertion • Set screws are inserted into each hook or screw • Each screw is hand tightened

  30. Scoliosis Rod rotation • The deformity is corrected using the appropriate method. • Compression and distraction may be applied to gain additional correction.

  31. Scoliosis Bone grafting and crosslink plating • Bone grafting is completed. • Cross links are measured for and applied to the construct.

  32. Scoliosis Final tightening and closure • A counter torque and break off driver are used to torque and break off the plugs.

  33. Scoliosis Completed Posterior Spinal Fusion

  34. Scoliosis Anterior Surgical Approach

  35. Scoliosis • Disc removal • Screw & rod placement

  36. Scoliosis • Endoscopic Anterior Approach • Also known as a thoracoscopic approach

  37. Scoliosis • Endoscopic Instrumentation

  38. Scoliosis Endoscopic Anterior – Posterior Spinal Fusion • A combination of both procedures previously discussed. • An endoscopic anterior approach done first. Disc is removed in the most severe part of the curve to facilitate posterior fusion. • Posterior approach is then done to correct deformity with instrumentation and fusion.

  39. Scoliosis Image guidance • Helps in the accuracy of the placement of screws. • Reduces potential nerve, spinal cord, and major vascular damage. • No exposure to ionizing radiation in surgery.

  40. Scoliosis Image Guidance

  41. Scoliosis Scoliosis surgery using the image guidance system

  42. Scoliosis Image guidance instrumentation

  43. Scoliosis Image Guidance instrumentation

  44. Scoliosis Image guidance & spine instrumentation

  45. Scoliosis Other equipment needed for Spinal Fusion: • EEG monitor • Intra-operative X-Ray holder • Mayfield Table (if preferred)

  46. Scoliosis Complications of Spinal Surgery • Blindness • Brachial Palsy • Nerve Damage • Paralysis • Infection • Allergy to metal • Blood Loss • Blood Transfusion Reactions

  47. Scoliosis Spine Team survival tips: • Think • Plan • Organize • Position • Padding • Warmth • Documentation

  48. Scoliosis As in all surgical procedures, Teamwork is a must in Spine Surgery!

  49. Thank You! Questions?

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