The anterior approach for scoliosis surgery is done through an incision made in the front or, more commonly, the side of the body. The anterior approach may be used for middle or lower spinal curves.This technique is better for severe curves, including rigid curves in adults. But it has greater surgical risks than posterior surgery alone. Surgeons often use both the anterior and posterior approaches when they operate on a person who has scoliosis. Using this combination of techniques, surgeons can remove discs in the spine and graft bone into the spaces. This is done to help make the spine more correctable.Other techniques done with an anterior approach use large metal screws that are attached to each vertebra. Each screw has a large head with a hole for the passage of a rod that is tightened at each level. A brace or cast may be needed for about 6 months following surgery. This technique is not recommended for children younger than 10 years because of the small size of their
The cosmetic aspects of scoliosis and the braces used to treat it may greatly affect a child or teen.Teenagers may find wearing a brace devastating to their self-image. Most braces should be worn for 20 hours a day or more, usually for several years. It is very difficult to get teens to wear the brace for as many hours as their doctors recommend. They don't like how the braces look or feel. Also, wearing a brace may limit activities such as horseback riding, skiing, skating, and gymnastics. Other activities, though, such as biking, tennis, running, and jumping, are safe to do while the brace is worn. It is typically recommended that children be allowed to remove their braces to take part in physical education classes and other highly desired activities. This may encourage better use of the brace.Newer braces are designed to improve the chances they will be worn as recommended.
The Risser sign helps measures the risk that a curve in the spine (scoliosis) will get worse, or progress. It measures how much mature bone has developed (ossification) in the upper rim of the pelvis (iliac crest). Values range from 0 (least ossification and greatest risk of progression) to 5 (complete ossification and least risk of progression). This is determined by an X-ray.