Child Orthopedics

Frequently Asked Questions

Our daughter has a scoliosis that is getting worse every year. We think she will probably end up having surgery fairly soon. The surgeon is only going to fuse part of her thoracic spine. Why don't they go all the way down to include the curve at the bottom?

Selective thoracic fusion (just fusing a portion of the thoracic spine) works well for some children with adolescent idiopathic scoliosis (AIS). Idiopathic refers to the fact that there is no known cause for the scoliosis.

Surgeons use measurements taken from X-rays to calculate angles, magnitude, and flexibility of the curves. From this information, they are able to determine who would be a good candidate for selective thoracic fusion.

You can expect the surgery to correct the thoracic deformity (both the spinal curve and the rotation of the vertebrae). The surgeon will preserve as much motion as possible above and below the fused area. In most cases, the lumbar curve corrects itself. This is referred to as spontaneous lumbar curve correction (SLCC).

Spontaneous correction occurs even when the first lumbar curve is included in the fusion. The more flexible the thoracic curve is, the more likely the lumbar curve will self-correct. More studies are needed to find out how much of the thoracic (and lumbar) vertebrae should be included to get the best results.

Prerana N. Patel, MD, et al. Spontaneous Lumbar Curve Correction in Selective Thoracic Fusions of Idiopathic Scoliosis. In Spine. May 1, 2008. Vol. 33. No. 10. Pp. 1068-1073.

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