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Problems after Adult Scoliosis Surgery


Problems after Adult Scoliosis Surgery


Scoliosis in an adult can lead to significant pain and disability. Non-operative treatment is not always successful in treating this condition and thus in a small group of patients surgical treatment may be considered. The operative care for adult scoliosis is complex and requires and experienced team. Even in the very best centers the results are not always good and complications are unfortunately not uncommon.


There are a number of things which may not go as planned in the setting of adult scoliosis. The surgery is often long, blood loss may be heavy and risks of nerve irritation/injury, infection and poor healing are high. Even after the initial surgical period, complications or poor results may become apparent due to loss of proper spinal balance (flatback, kyphotic decompensation syndrome, flatbuttock), failure of good bone healing (pseudarthrosis) and degeneration or failure of unfused levels of the spine (decompensation, instability).


If a spinal fusion is performed in addition to decompression for spinal stenosis then several problems may arise. One common problem is a failure of the spinal fusion to properly heal (failure of fusion, pseudarthrosis). Other problems include adjacent degeneration next to the fused levels, poor alignment of the fusion, poor placement of instrumentation, or failure of instrumentation.


The treatment of poor outcome after surgery for adult scoliosis is a very difficult area. Few specialists and centers are experienced and equipped to manage these very challenging cases. Once a thorough evaluation has identified the source of trouble, revision surgery may be considered in some cases. Correcting problems of balance, instability and failure of bone healing can be successful but the risks involved with revision surgery are not small.



Learn more about Revision Surgery in our Revision Surgery Tutorial.

For more information on adult scoliosis surgery, click here.





Figure 1
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Adult scoliosis

Figure 2
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Adult scoliosis
Figure 3
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Adult scoliosis
 


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