New Way to Treat Scoliosis

A new neuronavigational technique similar to the one NASA uses to navigate a robotic arm in space is making it possible to operate on severe cases of scoliosis, or curvature of the spine, in a minimally invasive, low-impact manner. The new procedure, which is performed only on those relatively few patients with a spine curvature greater than 45 degrees, avoids the extensive muscle damage, long scars and significant blood loss of traditional scoliosis surgery.

The surgery, which is still experimental and available at only a few medical centers, has the potential to replace the older approach, said Frank La Marca, director of the Section of Spine Surgery in the University of Michigan Department of Neurosurgery.

"Only time will tell how well patients do, but so far, our patients have been able to return to work much quicker, their post-operative course has been shorter, and their post-operative pain has been less," he observed. "My hope is that this actually becomes the standard of care on a national scale in the future."

Approximately one in every 10 adults over 40 has some level of scoliosis, he said. Of that group, one-tenth may have a severe-enough disorder to allow surgery. Among children, some one in 333 develops scoliosis, but only three to five of every thousand of them need surgery.

The traditional surgical approach to correcting scoliosis is to straighten the spine using metal rods and screws, and, furthermore, to graft small pieces of bone onto the vertebrae to fuse them together. In this procedure, while the positives outweigh the negatives, the drawbacks are enormous.

 In addition to the scarring and blood loss, the surgeon has to cut the muscles attached to the spine in order to allow for the placement of the hardware, resulting in back weakness and chronic back pain. But with the new surgery, only very small incisions are made, and the muscles are left intact.

The surgeon maneuvers the hardware and his instruments between the muscle fibers using the NASA-like navigational technique. In addition, La Marca and his team use new biological materials, including synthetic proteins, to accelerate the spine's fusion.