Scoliosis: Spinal Instrumentation Without Fusion

Topic Overview

Spinal instrumentation without fusion for scoliosis involves attaching devices (such as metal rods, hooks, wires, and screws) in or near the spine to correct a spinal curve without actually fusing the vertebrae together. The goal of this surgical procedure is to stabilize a severe spinal curve in a growing child without fusing an area of the spine that would stop growth in that area.

This procedure is used, with some limitations, on children who are still growing and have severe spinal curves that are getting worse.

Benefits of this procedure include that it:

• Allows for normal vertical growth of the spine.
• May stabilize a severe spinal curve.
• Prevents a spinal curve from getting worse.

Limitations of this procedure include:

• Possible complications from surgery, such as devices that do not stay in place or break, the need to remove devices due to infection or other problems, or the need for another surgery.
• The need for several surgeries (as many as six surgeries, or two surgeries a year) to lengthen the devices.
• The need to wear a full-time brace.

Spinal fusion surgery is needed when the child is nearly finished growing.

Despite these limitations, the use of instrumentation without fusion is an important alternative for some children who have severe scoliosis and who are still growing.