Common Questions When Considering Scoliosis Surgery
When should surgery be scheduled?
Most scoliosis surgeons agree that there is rarely a need for emergency or urgent surgery. Most surgeries can be scheduled for a time that works for both the patient and the doctor. If you decide to postpone your surgery until a school break, your doctor will follow up with you every few months to make sure there is not a rapid increase in the size of the curve once it is greater than 50 degrees.
Should I have allograft bone used for my fusion or my own bone harvested?
At this time, your own bone is still an excellent option, but many scoliosis surgeons now use allograft bone instead. The reason for this is that some patients end up having pain at the donor site (from where the bone was taken) and this can last a long time. Other problems such as bleeding, nerve irritation, infection, or fracture can happen on rare occasions.
Allograft bone is taken from a deceased donor. It goes through an extensive sterilizing (cleaning) process before it is used on a patient. Allograft bone is often mixed with the patient's own marrow blood to improve its bone fusion capability.
In addition, spine surgeons are also using synthetic (artificial or man-made) products to get the spine to fuse. These products can be used with your own bone or with an allograft (donor bone). They act as a scaffold (framework) to allow new bone to form and mature. Some of the synthetic materials available can actually stimulate new bone to form in the operated area. They go by the name BMP (stands for bone morphogenetic protein) and your surgeon may bring it up while discussing your surgery. It has been used extensively in the spine and other bony areas in the body for the past several years.
The exact type of bone graft used will depend on many factors, the most important of which is surgeon preference and experience. That is to say, if your surgeon has had very good success with one method or approach, he or she will probably recommend it to you. Of course you and your family should ask about other options available to you and then decide which method you would prefer.
How much does spinal fusion surgery cost?
The cost of surgery for scoliosis and other types of spinal curvatures depends on many factors. They include the cost of being in the hospital for several days, types of materials used (hooks, screws, rods), bone graft material, surgeon's fees, and anesthesia charges. Unexpected events that result in an extended hospital stay will also increase the overall cost.
The actual costs vary from region to region in the United States, and from country to country.
In the United States, costs also vary depending on the type of insurance coverage you have. Many insurance companies cover the cost of the surgery, the hospital stay, and the instruments to straighten the spine. You may owe a co-payment or you may be billed the balance of what your insurance does not cover.
Be sure to contact your insurance provider prior to surgery to discuss the extent of your coverage. Talk with your doctor's office, as well as the hospital billing department to make sure you understand all the costs involved.
Although the exact costs vary from patient to patient, in general, spinal surgery for scoliosis is an expensive operation.
How many spinal surgeries has my surgeon performed and has he or she had good results?
Talk with your surgeon. Because not all spinal surgeons treat scoliosis patients, it is important to ask your surgeon if treating scoliosis is an important part of his or her practice. There are many regional spine centers and teaching institutions that specialize in treating teenagers with scoliosis and other curvatures of the spine.
Should my child see a neurosurgeon?
The vast majority of surgeries for scoliosis and other curvatures of the spine have been performed by orthopaedic spine surgeons. Over the last several years, however, some neurosurgeons have taken a special interest in treating teenagers with scoliosis and have gone through specialized training.
Certain types of curvatures are associated with problems related to the spinal cord. If your child has other symptoms with the curve, like pain, weakness, or numbness, it may mean that the nerves from the spine are being compressed by the bones or the disks. This is rare, but should be watched out for. A neurosurgeon may be requested to be a part of the surgical team.