How to recover and live after surgery for congenital scoliosis?

Author: Shen Jianxiong, Chief Physician, Peking Union Medical College Hospital

Reviewer: Zhang Zhihai, Chief Physician, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

Scoliosis is a common skeletal deformity, among which congenital scoliosis requires special attention during treatment and rehabilitation due to its special etiology and development pattern. With the advancement of modern medical technology, many children with congenital scoliosis have achieved significant correction effects through surgical treatment and are able to gradually resume normal daily life and activity ability after surgery.

However, from the operating room to returning to normal life, patients and their families face a series of challenges, including how to properly conduct postoperative management and recovery, how to adapt to postoperative changes in life, and how to deal with some common questions and misunderstandings.

After surgical treatment, the recovery path of patients with congenital scoliosis needs to be carefully planned. According to the surgical plan and individual differences of the patients, some children need to wear braces as external fixation protection. This measure is mainly based on the consideration that children's bones are relatively soft and the stability of internal fixation is limited. With the assistance of the brace, it is possible to effectively prevent the loosening or failure of internal fixation caused by the activities of the child, thus ensuring the effectiveness of the surgery. Generally speaking, the brace needs to be worn for three to four months. After the child's bones have healed and stabilized, it can be removed and the child can resume normal life.

During the recovery period, the child's diet should be the same as that of ordinary people. No special supplements are needed. Just maintain a balanced nutrition. In terms of life, in the early stage, because the bones have not yet fully healed, strenuous exercise and excessive activity should be avoided to avoid affecting bone recovery. As time goes by, the child can gradually resume daily activities, but regular follow-up examinations should be paid attention to monitor bone growth and functional recovery.

Figure 1 Original copyright image, no permission to reprint

Postoperative review and follow-up are important steps to ensure the smooth recovery of the child. The first review is usually conducted three months after the operation, mainly to check whether the internal fixation is stable, whether there is loosening or damage, as well as the wound and nerve function. Thereafter, a review is conducted every six months to evaluate the bone recovery and functional improvement. Given the presence of metal internal fixation in the body, it is recommended to continue regular review within a few years after surgery to ensure the long-term health of the child.

Rehabilitation is not only about the physiological level, but also involves a comprehensive adjustment of lifestyle. For most children with congenital scoliosis, after surgical treatment and effective rehabilitation management, they can recover to a level close to or reaching that of a normal person. They can go to school normally, participate in sports activities, and even engage in occupations that require high physical fitness, such as special police. Of course, this result also depends on the severity of the disease, the effect of the surgery, and the postoperative rehabilitation of the child.

It is worth noting that although patients with congenital scoliosis can return to normal life after treatment, they may still face a certain degree of social prejudice and discrimination. Therefore, all sectors of society should strengthen scientific understanding of the disease, eliminate prejudice and misunderstanding, and create a more inclusive and friendly social environment for patients.

For some children with lung dysfunction or other complications, targeted rehabilitation treatment and functional assessment are required under the guidance of doctors. Through cardiopulmonary function tests and other testing methods, the children's exercise tolerance and lung function level are assessed, and personalized rehabilitation plans and career plans are formulated for them.

Faced with questions about life after surgery, such as flying, MRIs, fertility and genetic issues, and the difference between early-onset scoliosis and congenital scoliosis, patients and their families need accurate information to eliminate misunderstandings.

About flight and MRI examination:

Children with metal internal fixation in their bodies may trigger security alarms when they are on an airplane. In this case, the child can explain the situation to the security personnel with a certificate issued by the hospital to obtain a pass. In addition, with the advancement of medical materials, modern internal fixation materials such as titanium-nickel alloys have no effect on MRI examinations, so children can rest assured to undergo relevant examinations.

Figure 2 Original copyright image, no permission to reprint

Fertility and genetic issues:

Congenital scoliosis has no direct effect on female fertility, and patients can still become pregnant and have children normally. However, there is no definite conclusion about the inheritance of this disease. Both genetic and environmental factors may play a role, but the specific mechanism needs further study. Therefore, children with a family history should undergo regular spinal health examinations to detect and intervene in potential problems in a timely manner.

The difference between early-onset scoliosis and congenital scoliosis:

Early-onset scoliosis refers specifically to scoliosis that occurs before the age of 10. Its treatment needs to consider the growth potential of the spine, and growth rod technology is usually used to promote the synchronous growth of the spine and thorax. Congenital scoliosis focuses on the congenital factors of the cause. The two are different in definition, but there may be some overlap in clinical practice. The treatment of children with early-onset scoliosis needs to be personalized according to the specific situation.