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"When there's a significant spinal defor- mity, patients can suffer from pain in their back and legs that makes getting out of bed and walking difficult." Conser vative treatments, such as physical therapy, pain medications and injections — which are inherently chal- lenging to administer with precision because the spine's curvature obscures the path to the nerve root — are not always successful. Surgical Scoliosis Correction Scoliosis common ly present s in children 10 to 15 yea rs old a nd is equally prevalent in boys and girls. Nevertheless, girls are eight times more likely to require surgical intervention, according to the NSF. Dr. George notes that many operations are performed to correct thoracic cur vatures, and a lthough ever y case is unique, the optimal operation for many is open posterior fusion. Dr. George fuses vertebrae via a bone graft, preventing bone movement and any further curvature. After correcting the deformity, Dr. George uses screw systems, hooks and hybrid constructs to hold the spine in the desired position. Using novel surgical instrumenta- tion, Dr. George reduces the risk for blood loss a nd postoperative pa in. The Aquamantys System combines radiofrequency energ y and saline to hemostatically seal soft tissue and bone intraoperatively. The bipolar coagula- tion device prevents blood loss — an especia lly important consideration for children and older patients with cardiovascular diseases. Additionally, because fusion surgeries tend to take longer, the risk for infection can be higher. To alleviate this risk, Dr. George uses vancomycin powder in the wound. One important preoperative consid- eration is the presence of secondary cur ves that result from the body's tendency to compensate for the initial scoliotic curve. These must be identi- fied as secondary and do not require fusing because they are not structural malformations. Rarely, patients will present with double structural curves, and in these cases, both sections of the spine require fusion. Proceeding with Care Novel approaches to fusion surgery, combined with technological innova- tions, make surgical intervention for scoliosis highly effective and safe. "We have a large practice, which allows each of us to focus on particular disease processes. Area physicians have easy access to university- level spine services with advanced technology in a private community setting." — Zachariah M. George, MD, partner and neurosurgeon at Neurological Surgery, P.C. Dr. George examines a patient in his Commack office. Intraoperative views from a minimally invasive correction of scoliosis performed by Dr. Vaynman M D N E W S . CO M ■ MD NEWS Long Island | 7