Spinal Structure - Research Paper Example

The spine is composed of vertebral bodies connected to one another by ligaments and strengthened with the support of back muscles. The body of the vertebrae bears the weight to support the upper body. Aside from supporting the body, it also protects the spinal cord, from which spinal nerves branch off. The stability of the whole spinal structure is provided for by four facet joints in each vertebra, which attach to the facet joints of vertebrae above and below it (Southern California Orthopedic Institute, 2010).

Scoliosis is one of the several defects of the spine in which it abnormally bends sideways. This abnormality is caused by a rotational deformity that makes the spine corkscrew around its axis (Southern California Orthopedic Institute, 2010). A plain X-ray can usually clinch the diagnosis. However, if a certain independent structure is causing the abnormality, such as a tumor, the doctor may request for more imaging tests such as magnetic resonance imaging, CT scan, and/or bone scan (Mayo Clinic, 2009). Upon proper analysis of the condition, surgery may be suggested to prevent the further bending of the spine, especially when non-operative bracing has failed to do so, and to repair any cosmetic deformity and postural discomfort caused by scoliosis (Southern California Orthopedic Institute, 2010).

Before the surgery, an anesthesiologist may use an epidural catheter inserted in the back to control pain at the end of the procedure. A blood sample will be taken for a blood count. Clotting should be normal to facilitate wound healing. As such, medications such as NSAIDs should be avoided two weeks before surgery. Antibiotics are given 24 hours before the operation as a prophylaxis against potential infection.  Anything taken through the mouth will be prohibited six to twelve hours before the procedure unless it is for the operation (Zieve and Ma, 2011).

An incision is made in the middle of the back. The back muscles and joints are moved to expose the spine. Vessels that can potentially cause bleeding are also cauterized. The vertebrae are roughened up to induce bone production. Metal implants, rods, screws, hooks, or wires are used to stabilize the spine while the bone fuses. An autogenous bone graft, usually from the pelvis of the patient, or an allogenous bone graft from the bone bank, is used to augment bone fusion, After the placement of supporting structures, the incision is pressurized prior to closing to prevent microbial growth. A catheter is placed in the bladder so that the patient will not have to walk to the bathroom a few days after the surgery. The catheters are removed at least three days after the surgery (University of California San Francisco Medical Center, 2011).

During recovery in the hospital, pain medications are given orally or parenterally. Moving the spine is strictly prohibited, a back brace or cast may be put on to prevent movement. Nutrients are to be given through an intravenous line. Before being discharged, spinal X-rays are taken post-operation Physical therapy is also recommended to hasten recovery and return to normal function. The dressing of the wound is kept until the next follow-up visit. As such, a sponge bath is recommended. For the first six months, physical activity should be limited to personal care, bending, and walking. Lifting heavy objects, running, or jumping is strictly prohibited. Six to eight months post-surgery, a physical examination and spinal x-ray are conducted to assess the recovery of the patient. When all is going as expected and no complications are seen, more strenuous activities, such as swimming, are allowed. Eight to ten months, closed chain kinetic exercises such as biking are recommended. If the patient has fully recovered, in ten to twelve months, running, jumping and solo sports are already allowed (University of California San Francisco Medical Center, 2011).