Pre-operative x-rays
The Spine Exposed Scoliosis surgery in Brunei
In early July 2007, the department of Neurosurgery RIPAS hospital had organised for the first time Scoliosis surgery to be undertaken in the country. A Professor of Orthopaedic Surgery with a specialist interest in Spine from India was brought into the country through sponsorship of a drug company and performed 3 Scoliosis surgery with the help of our Neurosugeons.
A little bit about Scoliosis surgery:Surgery for scoliosis is only recommended for patients with curves that are greater than 40 to 45 degrees and continuing to progress, and for most patients with curves that are greater than 50 degrees. The main objective of scoliosis surgery is to fuse the spine so that the curve will not continue to progress into adulthood.
Only more severe curvatures (greater than 50 degrees) are likely to progress in adulthood. If a curve is allowed to progress to 70 - 90 degrees, it will not only result in a very disfiguring deformity, but will start to result in cardiopulmonary compromise. This happens because the curve in the spine rotates the chest and closes down the space available for the lungs and heart.
Besides preventing further curvature, scoliosis surgery can also reduce the amount of deformity. Usually, about a 50% correction can be obtained with surgery using modern instrumentation systems in which hooks and screws are applied to the spine to anchor long rods. The rods are then used to reduce and hold the spine while bone that is added fuses together.
Once the bone fuses, the spine does not move and the curve cannot progress. The rods are used as a temporary splint to hold the spine in place while the bone fuses together, and after the spine is fused the bone (not the rods) holds the spine in place. However, the rods are generally not removed since this is a large surgery and it is not necessary to remove them. Occasionally a rod can irritate the soft tissue around the spine, and if this happens the rod can be removed.

Following scoliosis surgery, patients can usually start to move around about 2 to 3 days after the surgery and when they start feeling better, and total hospital stay is usually about 4 to 7 days. Patients can return to school about 2 to 4 weeks after surgery, but their activity needs to be limited while the bone is fusing.
It is important to note that the more immobile the spine is kept the better it will fuse. Bending, lifting, and twisting are all discouraged for the first three months after surgery. For this reason, some surgeons will prescribe wearing a back brace for a period following the surgery. Any physical contact or jarring type activities are restricted for about 6 to 12 months after surgery.
Generally the patient will be monitored with intermittent examinations and x-rays for 1 to 2 years after the surgery. Once the bone is solidly fused no further treatment is required.
For the most part, patients can resume normal activity levels after a thoracic fusion since fusing the thoracic and upper lumbar spine does not change the biomechanics of the spine all that much. Female patients who have had a scoliosis fusion can still become pregnant and deliver babies vaginally.
adapted from spine-health.com