Adult Scoliosis and Spinal Deformity Surgery
Some patients told they need a large operation turn out to need a much smaller one. The evaluation is what tells the difference.
What Spinal Deformity Means.
Spinal deformity means the spine has lost its normal shape. The most common type is scoliosis, which is a curve to the side. It also includes kyphosis, which is too much forward rounding, and the loss of the normal inward curve in the lower back. In adults, these curves usually happen because the discs and joints wear down unevenly over many years. A curve that started in the teenage years can also get worse in adulthood for the same reason.
When Reconstruction Is the Right Operation.
Reconstruction surgery straightens the spine and holds it in place. It is the right choice when the shape of the spine is what causes the symptoms. That can be pain from the curve itself. It can also be a pinched nerve, because the bones have shifted out of line. Some patients find it hard to stand up straight or to walk very far.
Disc replacement and endoscopic surgery can take pressure off a pinched nerve. Neither one can straighten a spine. So when the curve is the problem, the operation is a fusion. Implants hold the spine in its corrected position while the bones heal together.
When a Smaller Operation Will Do.
Not every patient with a curve needs a large operation. Symptoms that seem to come from a curve can actually come from one pinched nerve, or one worn-out disc, inside that curve. When that is the case, the problem can sometimes be treated with a smaller operation that takes the pressure off that one nerve.
Figuring out which one is causing your symptoms is the point of the visit. It is worth doing before you agree to a big surgery.
How the Evaluation Works.
Dr. Hirsch starts with X-rays taken while you are standing. A curve behaves differently when your body weight is on it than it does when you are lying down in a scanner. An MRI is used along with the X-rays to show the nerves and the discs.
He then compares what the images show against where your symptoms actually are. A curve can look dramatic on an X-ray and still not be the reason you hurt.
Dr. Hirsch sees patients with scoliosis and spinal deformity at both the Newport Beach and Carlsbad offices.
Dr. Hirsch is board-certified and Yale-trained. Read his full background.