Minimally Invasive Surgery now an Option for Children With Scoliosis

Aug 30, 2011, 12:02 ET from Montefiore Medical Center

New Technique by Montefiore Medical Center Surgeon

Published in Journal "Scoliosis"

NEW YORK, Aug. 30, 2011 /PRNewswire-USNewswire/ -- Minimally invasive surgery to treat scoliosis in teenagers is now a "feasible option," according to Vishal Sarwahi, M.D., Director of Spine Deformity Surgery at Montefiore Medical Center.

"This new procedure to correct curvature of the spine involves three small incisions in the back, as opposed to standard open surgery, which requires a two-foot incision in the back," said Dr. Sarwahi.  "While there are significant technical challenges in the new procedure, it has proved as effective as open surgery and involves less blood loss during surgery, shorter hospital stays, relatively less pain and pain medication and helps patients become mobile sooner."

Dr. Sarwahi has performed seven of the innovative procedures, and published the first professional journal article in the world on the topic in the August, 2011 issue of Scoliosis (

Until now, children with scoliosis, who are mostly girls, have been treated with traditional open surgery, in which a surgeon opens up a large section of the back, separates many back muscles and then places rods, screws and bone grafts along the spine to straighten the curvature.   Dr. Sarwahi accomplishes all of the above through three tiny incisions in the back.    

When curvature of the spine is severe, patients with scoliosis experience back pain and problems with heart and lung function.  Scoliosis affects 60,000 school-age children in the United States, resulting in over 600,000 doctor visits.  An estimated 30,000 children are braced, while 38,000 patients undergo corrective surgery, according to the National Scoliosis Foundation.   Of these surgeries, 13,000 are teenagers.

The best candidates for the new procedure are adolescents with a routine spinal curvature of 40-70 degrees, said Dr. Sarwahi, who followed the seven patients over two years.

Minimally invasive surgery has been performed on adults with lumbar scoliosis in recent years, and the "next logical step is to apply minimally invasive surgical techniques to the treatment of adolescent scoliosis," said Dr. Sarwahi.  

The technical challenges Dr. Sarwahi and his team were able to overcome in the new procedure for children are significant.  The spinal curvature in adolescent patients is more severe (50-100 percent greater than in adults);  the number of vertebra requiring fusion is generally higher (from 7-13 vertebra); radiation exposure is greater due to multiple x-rays required to help place screws in each of the vertebrae; and the spine is twisted into three planes, which makes surgery more complex.

The new, minimally invasive technique takes longer than open surgery, said Dr. Sarwahi, but he believes the time in the operating room will be reduced as the procedure is performed in greater numbers.  

In the study of seven patients, the surgeons limited the technique to curvature of the spine that was less than 70 percent. The technique provided "similar deformity correction as a standard open posterior spinal fusion," said Dr. Sarwahi.  

Montefiore Medical Center
As the University Hospital for Albert Einstein College of Medicine, Montefiore is a premier academic medical center nationally renowned for its clinical excellence, scientific discovery and commitment to its community. Recognized among the top hospitals nationally and ranked sixth out of 180 in the New York metropolitan area by U.S. News & World Report, Montefiore provides compassionate, patient- and family-centered care and educates the healthcare professionals of tomorrow. The Children's Hospital at Montefiore is consistently named in U.S. News ' "America's Best Children's Hospitals,"  and is second among those in the New York metro area. With four hospitals, 1,491 beds and 93,000 annual hospital discharges, Montefiore is an integrated health system seamlessly linked by advanced technology.  State-of-the-art primary and specialty care is provided through a network of nearly 100 locations across the region, including the largest school health program in the nation and a home health program. Montefiore derives its inspiration for excellence from its patients and community, and continues to be on the frontlines of developing innovative approaches to care.

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SOURCE Montefiore Medical Center