Operative treatment of scoliosis. Preoperative planning, intraoperative monitoring, and postoperative management

Background. The indication for the surgical treatment of thoracic, lumbar, combined, and thoracolumbar idiopathic and neuropathic scoliosis is a Cobb angle of more than 50A degrees in the thoracic and more than 45A degrees in the lumbar spine. The success of the operation is highly dependent on the pre-operative indication. Standardized medical imaging and close collaboration with anesthetists and pediatricians are necessary in complex cases. Methods. We developed a screening routine in which pre-operative diagnosis is performed during hospitalization. The concept is individually developed across disciplines. Surgery for childhood scoliosis always presents a particular challenge for anesthetists and surgeons. Close collaboration during surgery is indispensable for guaranteeing success. Risk factors are determined, evaluated and-if necessary-treated before performing surgery. These factors are also strictly monitored and dealt with during surgery. Result. Regular post-operative check-ups are required to ensure early determination and adequate treatment of complications. Conclusion. Operative treatment of scoliosis should only be performed in medical centers that allow for close collaboration and diagnostic investigation.