Indications for Surgery (Scheuermann's Disease)

• Thoracic kyphosis > 75 degrees
• Rigid kyphosis > 55 degrees
• Persistent back pain

Before Surgery

Usually 5-6 units of blood are needed for this surgery. Many patients prefer to give 6 units of blood beforehand (1 every week, to be completed 1 week before surgery), even though the blood supply at the hospital has been properly tested and should be safe. Most patients do fine with their blood donations, but it can make you a little weak, nauseated and dizzy.

The Operation

• The surgery often takes about 6-10 hours.
• Occasionally surgery can be done by only working on the back of the spine.
• Usually the physician needs to work on the front and back of the spine. It is called anterior (front) and posterior (back) spinal fusion with instrumentation. This means that the physician "roughs up" the vertebrae so that the bone grafts heal together with the vertebrae, to form one column of solid bone (fusion). Along both sides of the spine, metal rods (instruments) are used to hold the bone in place while it heals. The bone heals around them, so the rods, grafts and vertebrae all become one solid unit. Therefore, the rods are never taken out.
• An incision is made along one side of the ribs in front--to loosen things up in the front part of the spine, and to obtain a portion of the rib for bone graft.
• The longest part of the surgery is when the physician works on the back itself.
• If additional bone grafts are needed, the physician may obtain them from the hip, using the same incision used for the back part of the spine.

After Surgery

• The length of stay in the hospital is usually 7-10 days, provided there are no complications.
• No bending or twisting, or lifting more than 10-15 lbs. for 6 months after surgery.
• There are limitations to what is allowed when lying down and sitting also.
• 80% of the bending and twisting is done below the area operated on (for thoracic curvature), so even though there will be more stiffness than before, there should still be sufficient movement.
• Six months to one year after surgery, if the X-rays show proper healing, normal activity is resumed. Although participation in contact sports is not recommended.
• On rare occasions, an area may not heal properly, so another surgery is needed to correct this.