New Procedure for Scoliosis Leaves No Scars

Today, 13-year-old Tennisha Malone is standing straight and tall as she puts the finishing touches on her Christmas tree — but that hasn't always been the case.

During a routine physical, her pediatrician had turned up a major deformity: Tennisha had scoliosis, joining the ranks of 6 million people who have varying degrees of curvature in their back. An X-ray showed that there was an 82-degree curve in her spine.

Instead of growing upward, her spine was curving outward, looking more like a "C" than a straight line. Her ribs began to protrude from the side of her body — a frightening and embarrassing condition for any child.

Almost 4 percent of children have scoliosis, though not all cases involve enough of a curve in the spine to require treatment. In severe cases, surgery is required.

Scar-Filled Past Gone

In the past, scoliosis surgery often left patients, more often girls than boys, with very large scars, but that isn't the case anymore.

A cutting-edge technique is available to children at a handful of hospitals across the country, including the A.I. Dupont Hospital for Children in Wilmington, Del., home to the nation's largest pediatric orthopedic center.

This new procedure, called video-assisted thoracoscopic anterior spine fusion, requires four incisions between the ribs, each about a half- inch long. Guided by images transmitted from a camera inside the body, doctors remove some of the flexible tissue between the bones in the spine. Then a steel rod is inserted, along with pins and pieces of bone to secure the remaining bones.

Tennisha is one of those who underwent the new surgery at A.I. Dupont. The teen said she approached the prospect of surgery with some trepidation.

"When they told me I was going to have surgery for scoliosis I felt nervous and scared because of the thought of them cutting me open and putting something in my back," she said.

Active After Two Months

Dr. Suken Shah, a pediatric orthopedic surgeon at A.I. Dupont Hospital for Children, said that the surgery has numerous benefits.

"We find with the new procedure that because the patients have less pain, they need less narcotics, they're less sedated, they have a quicker recovery overall

Previously, invasive surgery, which required doctors to make a big incision down the back and spread open the ribs, was the only option. It was an option followed by a long, painful recovery period. Now kids like Tennisha are up and active just two months after surgery.

"I'm very anxious to get back to the regular activities I like to do," Tennisha said.

Shah said the surgery has made a big difference.

"This has been a breakthrough in spinal surgery," Shah said. "We can do the same type of surgery with smaller incisions and a shorter hospital stay. And with technology improving our optics and instruments we use, this has come to the point now that we can recommend this to our patients and have excellent outcomes."

Children with severe curves in their lower backs aren't eligible because doctors don't have the tools to take pictures of that part of the spine. The best candidates are those with a deformity in the upper part of their backs.

To learn more about the hospital featured in this piece, go to nemours.org

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