☆ Q: What are the types of corrective surgery for scoliosis? A: We often refer to corrective surgery as corrective fusion surgery. Corrective fusion surgery involves the placement of a metal nail bar stent in the body that straightens and maintains the curved spine, which is equivalent to a metal brace placed in the body. It is not enough to rely on the stent alone to maintain the spine, but at the same time, bone grafting is also performed, which means that granular bone is placed on the dorsal side of the spine, which will hold the spine in place after it heals, just like welding the spine in place. Therefore, the metal brace actually loses its role in supporting the spine about six months after surgery, and the maintenance of the spinal curvature then depends mainly on the fused granulated bone. In addition to corrective fusion surgery, there are some special types of scoliosis surgery, including hemivertebrectomy, growth bars and minimally invasive navigation surgery. ☆ Q: What does hemivertebrectomy mean? A: Hemivertebrae means half of a vertebra. It is the most common form of congenital scoliosis. Normal vertebrae are symmetrical on the left and right side, while hemivertebrae are only on the left or right side, and the other side is not growing out. Our spine contains 7 cervical vertebrae, 12 thoracic vertebrae and 5 lumbar vertebrae, with one vertebrae falling on top of the other. If there is an asymmetry in one of the vertebrae, it will affect the overall shape. A hemivertebrectomy is the removal of this abnormal vertebra, which is then fixed with a staple, and then removed after 2-3 years to complete the treatment. ☆ Q: What does a growth bar mean? A: Growth rods are used for early onset scoliosis, which is when the scoliosis becomes apparent before the age of 10. Children before the age of 10 should not have corrective fusion surgery because once the corrective fusion surgery is done, the length of the child’s trunk is fixed, and the trunk of the child at this age has growth potential until the age of 18, so premature fusion will result in a loss of height, and because the lower extremities are still growing, the ratio of the trunk to the lower extremities will be higher in adulthood. The ratio of the trunk to the lower extremities can also be out of proportion. To address this problem, doctors have developed the growth rod technique. This is a surgical procedure in which a metal stent is placed through three small incisions in the upper and middle of the body. This metal stent corrects scoliosis and allows for a minor surgery to lengthen it every year. This buys the child valuable time to undergo the final corrective fusion surgery after the child is 12 years old, greatly improving the outcome. ☆ Q: What about minimally invasive navigational surgery? A: Minimally invasive navigation is a breakthrough achieved in recent years. It is based on the latest navigation equipment, combined with innovations in surgical techniques, and requires only three 5 cm incisions to complete a surgery that previously required a 40 cm incision, for acquired scoliosis of 90 degrees or less. Previously, scoliosis orthopedic surgery was considered to be a highly invasive and risky procedure. The advent of navigation devices has significantly changed this situation. First of all, traditional surgery is very invasive because the spine has to be clearly exposed before the screws can be placed, because traditional surgery relies on anatomical landmarks and the surgeon’s experience to place the screws. Navigation surgery is not necessary because it relies on intraoperative CT to place the screws without looking directly at the anatomical landmarks of the spine, which greatly reduces the incision and the damage to the back muscles. In the past, spine surgery was considered high risk because of the density of nerves and blood vessels near the spine. The advent of navigation devices has greatly increased the safety of surgery, as it is clear on the navigation screen where the vessels and nerves are, and the chance of damaging them is greatly reduced. Therefore, the use of navigation makes scoliosis surgery less invasive and safer. In addition, minimally invasive navigation can also correct cervical scoliosis, because navigation can place the cervical arch nail, which was difficult to do before without navigation, so cervical scoliosis can also be corrected.