Spine straightened: thoracic surgery

Juvenile from Saudi Arabia successfully operated in Lower Saxony: The spine has just been moved and the operation was performed through the chest

In young patients, spinal curvature, so-called scoliosis, is usually no longer painful at a young age, because the problems only appear at an advanced age. A young person from Saudi Arabia, in whom the disease was particularly severe, has now been successfully operated on in a specialist clinic in Lower Saxony.

Lateral bending of the spine The human spine looks like a straight, vertical line on a x-ray image of a healthy person. With 16-year-old Fahad Mulhem from Saudi Arabia, however, she looks like a question mark. Such a curvature or lateral bending of the spine is called scoliosis. A side bend in the spine can be congenital or can often occur in adolescence or childhood. It is usually difficult to determine the cause of non-congenital scoliosis, which can primarily or secondarily cause back pain, flank pain or lower back pain. Possible causes are static incorrect loads, metabolic disorders, hereditary factors, organic, muscular, connective tissue or neurological diseases or accidents.

Lower Saxony specialists The disease was particularly pronounced in the 16-year-old boy from the Saudi Arabian city of Khobar. That's why his spine was recently Karsten Ritter-Lang and his team from the Stenum Orthopedic Clinic in Ganderkesee, Lower Saxony, in a three-hour operation. "Although the disease was defined in the genetic code, it only broke out at the age of twelve," said Dr. Jan Spiller, one of the two surgeons. About two years ago, the doctors saw the deviation on X-rays for the first time the curvature is about 60 degrees. Meanwhile it is 80 degrees, with an increasing tendency.

Breast surgery Spiller explained that while scoliosis would not cause acute pain, surgery was to avoid long-term damage. The curvature of the spine would not only deform the chest, but also the lungs could not develop properly and the heart would be affected. Breathing difficulties and lung defects are likely. The operation was also almost impossible in adults. The operation was particularly complex because the doctors approached the spine from the front through the chest and did not operate from the back.

Clear ribs out of the way With the method, the ribs had to be cleared out of the way with a spreader in order to get free access to the spine. The doctors also let a lung collapse in a controlled manner. During the actual operation, the doctors removed a total of six intervertebral discs so that the vertebral bodies could be loosened in this way and to straighten the spine again. The vertebrae are then stabilized in their correct position and fixed with seven screws. "The principle is very simple: there is a screw in each vertebra, being careful not to injure the spinal cord," says Ritter-Lang. Because the screws are located in the area of ​​the thoracic spine, which is largely immobile anyway, the patient will not have any in the future Fear of movement restrictions.

Incorrect sitting and corsets According to the spine specialist Ritter-Lang, it has so far been largely unclear how scoliosis occurs. However, it can be ruled out that it has something to do with incorrect sitting, as was previously assumed. And the problem cannot be eliminated by wearing corsets, as was often tried until about 20 years ago. In the past, patients sometimes had to stay in the hospital for months after an operation, but today it is rarely more than ten days. It usually takes about two to three days for the lungs to recover and the patient to be transferred from the intensive care unit to a normal unit.

Standard in German specialist clinics The family from Saudi Arabia became aware of the orthopedic specialist clinic in Stenum, because of its former chief physician Dr. Hans-Georg Zechel had a long and friendly cooperation with the hospital in Khobar. Fahad's older brother was also operated there for scoliosis seven years ago. According to the parents, the 22-year-old is now in excellent health. Nowadays, an operation on a curved spine from the front through the chest is standard in German specialist clinics. The medical director in Stenum, Dr. Ritter-Lang, but emphasizes: "But you have to master the process." And further: "We specialize here." (Ad)

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