What is scoliosis?

A scoliosis is a three-dimensional curvature of the spine (back bones). A scoliosis can develop for a number of reasons and varies enormously in severity between individuals. There are many different types of scoliosis based on age and the type of curve however the most common scoliosis is known as AIS (adolescent idiopathic scoliosis). This means that a curve in the spine develops in adolescent years-growth spurt for no known cause. A curve can develop at any part of the spine and can be either a single or multiple curves resulting in a ‘C’ or ‘S’ shape when looking from behind.

Why am I having surgery?                        

Surgery is only considered for scoliosis when your curve becomes more severe or it has a significant effect on your day to day functioning. There are several different types of operation that can be considered to correct your curve and these will be discussed with you by your consultant.

What happens during surgery?

Once you are asleep your surgeon will make two incisions. The first will be at your side which allows access to the front of your spine. The second will be through the skin and muscles over your back. To access the front of your spine one of your lungs will be deflated during your surgery. Your consultant will then straighten your spine as much as it is safely possible to do so and a series of metal rods, screws and hooks will be inserted to hold the correction whilst a bony fusion occurs. This metal work stays in unless there is a problem in the future. To help your lung re-inflate properly you will have a chest drain inserted on the side of the incision.

What to expect after your surgery?

Walking

You will be seen by the physiotherapists the day after your surgery. They will check that your legs are working normally and that your chest (breathing) is okay. You will normally be allowed to start sitting up and standing with the assistance of the physiotherapists the day after your surgery.  You will be shown how to safely get in and out of bed by ‘log-rolling’ to protect your spine and you will be assisted to start walking and sitting out in a chair, you will be encouraged to walk regularly throughout the day.  By the time you go home you will be walking around the ward on your own.  You will also be shown how to get up and down stairs safely.

Breathing exercises

Due to the length of anaesthetic and nature of your surgery it is extremely important that you complete some breathing exercises following your surgery. These will help to ensure that your lung re-inflates properly and prevent complications such as chest inflection or collections of fluid around your lungs. You will be shown some breathing exercises to encourage you to take deep breaths and cough effectively. You will need to continue completing these whilst you are in hospital and also once you go home.

Other exercises

You will not be given any specific exercises for your back as it is essential that the bones heal properly. You are advised not to complete any form of bending, lifting or twisting for 6 weeks after your surgery. After this time you will be guided by your consultant. At home it is important that you gradually increase how much you are walking around, continue with your breathing and arm exercises and complete any postural advice that you may have been given by your physiotherapist on the ward. You will be reviewed in clinic by your consultant team at six weeks. If you require additional physiotherapy this will be considered at around six months post-operation.

Caring for yourself

It Is important that you start to complete your normal daily routine as soon as possible after your surgery. It is expected that you will need some assistance (either from your family or the nursing staff) to begin with however by the time you go home you should be able to get in/out of bed and care for yourself as you would normally do so. You will have been assessed by the occupational Therapist for any additional equipment that you may need to make things easier at home.

Pain relief

You will normally have an epidural and PCA (patient-controlled analgesia) for pain relief after your surgery. The epidural can make parts of your legs feel a bit numb after your operation. These will be stopped at around 24-48 hours after your surgery and you will be given oral medications to take instead. Due to the nature of your surgery it is expected that you will experience some pain afterwards. It is important to take these as prescribed to keep pain to a minimum and allow you to mobilise.

Bladder and Bowels

You will have a catheter inserted whilst you are asleep to allow us to monitor your urine output over the first few days after your surgery. This will be removed at the earliest opportunity.

Due to the combination of strong opioid painkillers, a long anaesthetic and reduced mobility you will become constipated. You will be given regular laxatives to help with this but may need more invasive assistance such as suppository or an enema.

Wound care

Your wounds will need to be kept clean and dry. If you develop any wound issues, for example as oozy wound, redness, swelling around the wound site, or a high temperature please liaise with Whitney Dalby, or the ward you were discharged from. The nursing staff will provide you with more information about wound care on discharge.

School/College

You can go back to school/college at around 4-6 weeks following your surgery, this is to protect your back and allow it to start healing properly. It is advisable that you (or your family) discuss this with your school as soon as possible as they may need to make appropriate plans for you. A phased return is recommended to allow you to gradually get back to your normal routine. If you require any support for this, please contact Whitney Dalby.                             

Sports and hobbies

You will not be allowed to complete any form of leisure or sporting activities for several months following your surgery. Your consultant or physiotherapist on the ward can advise you further on this.

Transition information

• You will be able to have a parent or someone to stay and support you during your time in hospital however they must be over age 18
• You will be able to choose from the young adult menu please ask for this if you do not get offered it
• You will also be entitled to reduced car parking please speak to Clare Hinwood for this (transition nurse)

Important contact numbers

• Whitney Dalby, Advanced Clinical Practitioner in Spines – 07767 215241
• Claire Hinwood, Transition Clinical Nurse Specialist – 07970 874392
• Physiotherapy Department between 8am - 4pm, Monday to Friday - 0121 728 9442

Useful websites

• British Association of Spine Surgeons: spinesurgeons.ac.uk
• Scoliosis Association UK: sauk.org.uk