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Kyphosis: Treatment and Recovery
Surgery
Surgery is indicated when (1) The deformity is progressive beyond severe angle (e.g., 70° for Scheuermann's kyphosis) or sagittal balance is significantly abnormal (2) Neurologic symptoms exist (3) When persistent pain cannot be alleviated using conservative treatment. In addition, adolescents with significant deformity, who may not respond to conservative therapy (e.g., bracing) and adults with curve progression and/or chronic back pain, may be accorded surgery.
Spinal Instrumentation and Fusion are surgical procedures that may be used to correct spinal deformity and to provide permanent stability to the spinal column. These procedures join and solidify the level where a spinal element has been damaged or removed (e.g., intervertebral disc). Instrumentation uses medically designed hardware such as rods, bars, wires, and screws. These devices hold the spine straight during fusion.
Fusion is the adhesive process joining bony spinal elements. In severe cases, spinal fusion is performed both anteriorly (from the front) through thoracotomy (entering chest cavity) and posteriorly (from behind) using instrumentation.
Recovery and Conservative Treatment
Closely follow the physician and/or physical therapist's instructions including regular follow-up visits to monitor curve progression.
Physical therapy may be incorporated into the treatment plan to build strength, flexibility, and increase range of motion. The therapist may provide the patient a customized home exercise program.
Recovery from Surgery
Post-operative pain and/or discomfort should be expected. Patient Controlled Analgesia (PCA) enables the patient to control their pain without hospital staff assistance.
PCA is eventually replaced by oral medication.
The patient may be encouraged to get up and walk the following day. Activity enhances circulation and healing.
Physical therapy is added post-operatively, enabling the patient to build strength, flexibility, and increase range of motion. The patient continues physical therapy on an outpatient basis for a period of time. Additionally, the therapist provides the patient with a customized home exercise program.
Before being released from the hospital following surgery, the doctor gives the patient written instructions and prescriptions for any medications. The patient will have follow-up appointments with their spinal surgeon to monitor their recovery.
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