Scoliosis Surgical Treatments: Anterior vs. Posterior Approach

Scoliosis can often be treated without surgery – with methods including bracing, physical therapy, injections, and medication. However, there are cases where the curvature of the spine or symptoms continue to worsen. Surgery is often recommended if a patient’s curvature is more than 40-45°, or when curves don’t respond to bracing.

There are several different approaches that a surgeon will use to correct spinal deformities such as scoliosis. Surgeons make decisions regarding the type of surgery that is appropriate for your case depending on the type, severity, and location of your particular spinal curve – including the traditional posterior approach, an anterior approach, or a combination of both.

Posterior Approach

Posterior spinal instrumentation with fusion is the most commonly used surgical procedure; it’s the most well-suited method for the majority of patients with scoliosis. This type of procedure is done with the patient lying on their stomach, then an incision is made down the middle of the back. Hooks, screws, and wires are then attached at established connection points each vertebral level of the curve. Metal rods are then implanted to correct abnormal curvature and are then secured to the previously established connection points. Once everything is in place and secure, a final tightening is done and the incision is closed. Post-operative hospitalization generally lasts between 4 to 7 days.

Anterior Approach

The anterior approach to scoliosis means that the surgeon will approach the spinal column from the front of the spine rather than through the back. The actual surgical incision and approach to the spine is through the side of the chest or abdomen rather than down the front of the body as many patients would envision it. The anterior approach allows surgeons to remove discs from the front of the spine, then place corrective spinal instrumentation, which sets up the spinal fusion. The choice to use the anterior approach is based on several factors including the type of scoliosis, location of the curvature of spine, ease of approach to the area of the curve, and the preference of the surgeon. An example of when this type of approach may be appropriate is when the patient has a severe curvature in either the middle of the spine or the lower spine. Post-operative hospitalization generally lasts between 3 to 6 days.

Anterior and Posterior Approach

The anterior and posterior, or “front and back” approach, involves a combination of two surgical methods. This approach is used most in patients that have severe stiff curves, in young patients to prevent crankshaft phenomenon, or to correct previous failed attempts to correct. First, the surgeon will make an incision on the side and remove disc material from the most severe part of the curve to increase flexibility. This can often require removal of a rib that is then used for bone graft. Next, is the posterior portion of the procedure, with a spinal instrumentation and fusion performed. With this method, the postoperative hospital stay and recovery process is generally longer, as the procedure is more involved than with a single approach.

The Spine Surgeon for Your Scoliosis Surgery

Choosing a spine surgeon is an important decision that can be intimidating and overwhelming. Dr. Anant Kumar specializes in adult degenerative cervical, thoracic and lumbar spine surgery, pediatric spine surgery, scoliosis, and complex spinal deformity. Unlike any other orthopedic surgeon in the country, Dr. Kumar has had additional subspecialty training in Orthopedics through four fellowships, a grueling process requiring an additional five years of training. Dr. Kumar has the ability to draw upon his extensive training and experience to find the most effective treatment for his patients. If you are looking for a skillful and reliable scoliosis surgeon in Colorado, schedule an appointment at Colorado Spine & Scoliosis today.