Having Minimally Invasive Scoliosis Surgery (Child)

Minimally invasive scoliosis surgery is a type of surgery done to fix an abnormal curve of the spine known as scoliosis. Surgery is usually recommended if the scoliosis has a curvature of 45 degrees or more. Before the curve is this severe, a brace is often used to prevent worsening of the curvature. Minimally invasive surgery uses two or more small cuts (incisions) instead of one large incision. This may lead to less pain after surgery, and faster recovery. Minimally invasive scoliosis surgery is not available at all hospitals or outpatient surgical centers.

What to tell the healthcare provider

Tell your child’s healthcare provider about all the medicines your child takes. This includes over-the-counter medicines such as aspirin. It also includes vitamins, herbs, and other supplements. Tell the healthcare provider about any recent changes in your child’s health, such as a fever.

Tests before the surgery

Before the surgery, your child may need imaging tests. These may include X-rays or MRI.

Getting your child ready for the surgery

Talk with your child’s healthcare provider about how to help your child get ready for surgery.

• Your child may need to stop taking some medicines ahead of time.

• Follow any directions your child is given for not eating or drinking before surgery.

• Follow any other instructions the healthcare provider gives your child before the surgery.

On the day of your child’s surgery

The procedure is done by an orthopedic surgeon. This is a surgeon who specializes in treating bone, muscle, joint, and tendon problems. They can help explain the details of your child's surgery. A typical surgery may go like this:

• Your child may be given general anesthesia. This is to stop pain and cause your child to sleep during the surgery. Or your child might have a type of anesthesia that only numbs part of their body. Your child will receive a medicine so that they will be very relaxed but awake during the surgery.

• Your child may be given antibiotics before and after the procedure. This is to help prevent infection.

• A healthcare provider will carefully watch your child's heart rate, blood pressure, and other vital signs.

• During the procedure, the surgeon will use a special type of X-ray to view your child’s spine.

• The surgeon will make several small incisions on your child's back.

• The surgeon will put a tubular retractor into this incision. This will let the surgeon reach the area of the spine with the problem.

• The surgeon will pass special small tools through this retractor. These include a tiny camera and a light.

• The surgeon will partly straighten the spine. This is done using screws, rods, and wires.

• The surgeon may use a bone graft to complete the repair. Bone is used from your child’s hip or from a donor.

• The surgeon will remove the tools and tube.

• The surgeon will close the incisions. They will put a small bandage on the wound.

After your child’s surgery

Your child will likely need to stay in the hospital for a few days or so. They may have some pain after the surgery. This is treated with pain medicine. Talk with your child’s healthcare provider about any over-the-counter pain medicines you can give your child. In most cases, the pain goes away fairly quickly. Your child can eat a normal diet as soon as they are able.

Recovering at home

The surgeon will give you instructions about how your child can use their back right after the surgery. Your child might need to limit movements that involve lifting or bending.

The healthcare provider can let you know how long to expect your child’s recovery will be. Your child may be able to return to school in 1 to 2 weeks. It may take a few months before your child can resume all of their normal activities. Over time, your child should be able to return to most activities, including possibly contact sports. Check with your child’s surgeon first.

Follow-up care

Your child will likely still have a slight curve in their spine after the surgery, but it should no longer be very noticeable. The surgeon will closely watch your child to make sure the surgery was successful. Follow all of the surgeon's instructions about your child’s follow-up appointments.

When to call your child’s healthcare provider

Call your child’s healthcare provider right away if your child has any of these:

• Fever of 100.4°F (38.0°C) or higher, or as directed by your child's healthcare provider

• Shaking chills

• A lot of fluid leaking from the incision

• Pain that is getting worse

• Numbness, tingling, or weakness in the arms or legs

• Symptoms of a blood clot in the leg (deep venous thrombosis, or DVT), such as swelling, pain, or both in one leg.