Scoliosis is a spine deformity that many people are somewhat familiar with. Someone who has a diagnosis of scoliosis may consider having spine deformity surgery when their quality of life is poor due to the curvature of their spine. However, as with all surgeries, there are a specific set of pre-operative tests that should be done before surgery can be performed to reduce the curvature of the spine in someone who has scoliosis, particularly if the patient has a wide range of unexplained symptoms and complaints.
Screen for Common Comorbidities of Scoliosis
For scoliosis patients, it is crucial to have a thorough screening for common comorbidities before deciding to go ahead with a fusion of the spine. Chiari malformation and syringomyelia are two comorbid conditions in 20% and 60% of scoliosis patients, respectively. Also, a tethered cord is often comorbid to Chiari 1 malformation and syringomyelia, so it's a good idea to get screened for tethered cord as well.
The reason for doing screenings for these conditions is that sometimes these conditions also require surgical procedures to improve quality of life and, sometimes, they are life-saving. If they are determined to need to be resolved by surgical procedures, the surgical team and neurologists should discuss which procedures would be more beneficial to do and in what order, depending on the outcome of the evaluations and imaging results. Screening for Chiari malformation, syringomyelia, and tethered cord involves a series of MRI & cine MRI scans.
Additional Pre-Surgical Tests if Comorbidities Are Discovered
If you are found to have a Chiari malformation with or without syringomyelia or tethered cord, you should also consider being evaluated by a geneticist for Ehlers-Danlos syndrome as part of your pre-surgical workup. Ehlers-Danlos syndrome is a connective tissue disorder that can cause subluxations and poor wound healing and is often comorbid to Chiari malformation and structural problems involving the head and neck junction where the spine meets the skull.
If you are diagnosed with Ehlers-Danlos syndrome, you should definitely push to have a minimally invasive spine deformity surgery instead of an open spine surgery due to your body being unable to heal properly. If your surgeon determines that your condition is too severe to be repaired via a minimally invasive procedure, your doctor must take extra precautions and additional measures to ensure your surgical wounds heal, such as the use of surgical glue instead of the use of staples when possible.