JEREMY L. FOGELSON: Mayo Clinic is a great place to refer your patients for spinal deformity treatment. That's because Mayo works as a team to take care of the patient in the best possible way. It's not just about the surgeon or one individual doctor. We really work as a team, to make sure the patient gets the treatment that they need and will be the most likely to help them, with the least invasive options as possible.
This might include radiology, helping perform injections, pain clinic to help perform different medications or stimulators, if needed. Physical medicine and rehabilitation to work on the rehabilitative options. And also to help capture other diagnosis that we might be missing. And then finally, surgeons who are really dedicated to excellence in treating this condition. Because it's really important to have a high volume in these types of surgeries, given the complexity and risk involved.
Many patients do not need scoliosis surgery because nonsurgical treatments can help a lot. Things like physical therapy, losing weight, taking medications. Injections can be used for scoliosis when there's a pinched nerve or there's arthritis in the joints of the spine. Also, sometimes people have scoliosis and don't have a lot of pain. So they don't need any major surgery or treatments.
Vertebral body tethering is a non fusion type surgery for scoliosis that can work in teenagers. It doesn't really work in adults very well because it's focused on utilizing the growth of the patient has to modify the curvature that's already occurred. In adults, the main surgical treatment of scoliosis is spinal fusion.
A spinal fusion essentially takes a vertebra that are moving and flexible, and turns them into a one longer vertebra. It takes away some of the motion in the spine, but that motion was causing the scoliosis in the first place and leading to the pain or bad alignment.
When you perform a spinal fusion, that basically takes two vertebra or more, sometimes many vertebra, and we glue them together with bone graft. We put screws and rods in there to act as a brace. But really we need those bones to glue together and that's the fusion. When we're performing a spinal fusion, we try to straighten the spine as much as we can safely. It doesn't have to be perfectly straight, but we straighten the spine as much as we can, without injury in the spinal cord or other nerves or causing too many other complications.
Mayo Clinic does have robots to help with safety and spine surgery. We can use these to help place screws and also to help plan out our surgeries more effectively. Not only are robots utilized, but also spinal navigation to help improve safety with spine surgery and improve operative time.
We've all heard of 3D printing but for spinal surgery it can be a really powerful tool. Essentially, we'll take a scan of the patient and then we'll print an actual model of their specific spine. And then during the surgery I can use that model to help guide the next moves that I'm going to make, the next techniques I'll utilize. And where I'm going to place various screws and how I'm going to loosen the bone up to improve the fusion.
Scoliosis isn't just about having surgery or one treatment option. Sometimes we can avoid surgery by doing physical therapy or injections or medications, and working with pain clinic type doctors. We have that entire team at Mayo Clinic. And we work together as a team to make sure the patient gets the treatment that's individualized to them and can help them obtain the best outcome, with the least invasive options as possible.
