Our Summary

This study looked at the use of growing rods (GR) in treating Early Onset Scoliosis (EOS) in patients who also had abnormalities within their spinal cord. The study included 46 patients, 13 of whom had one or more of these spinal abnormalities. The patients underwent a variety of surgeries, including 74 procedures that involved adjusting the GR.

The average age of the patients at the time of surgery was nearly 7 years. The majority of them had congenital scoliosis, which is present at birth. The study also found that the most common spinal abnormalities in these patients were tethered cord syndrome and split cord malformation.

Before the surgeries, the patients’ spines were very curved, with an average angle of about 78.5 degrees. After treatment, the average angle improved to about 53.1 degrees.

The study also noted 15 complications that occurred during or after the surgeries. These included problems with the implants, wound issues, anesthesia complications, and neurological issues. One patient suffered paraplegia after a fall, and another experienced changes in motor evoked potential during the initial surgery. However, none of the patients had neurological complications during the procedures to adjust the GR.

In conclusion, the researchers suggest that having a pre-existing spinal abnormality does not necessarily increase the risk of neurological problems during these types of surgeries. However, they recommend monitoring the nervous system during all initial surgeries and some follow-up procedures.

FAQs

  1. What is the average age of patients undergoing growing rod surgery for Early Onset Scoliosis?
  2. What were the most common complications observed during or after the surgeries?
  3. Does a pre-existing spinal abnormality increase the risk of neurological problems during growing rod surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to closely monitor any changes in neurological function before and after the procedure. It is important to communicate any symptoms such as weakness, numbness, or changes in sensation to your healthcare provider immediately. Additionally, following post-operative care instructions and attending all follow-up appointments is crucial for a successful recovery.

Suitable For

Patients who are typically recommended detethering surgery are those who have spinal abnormalities such as tethered cord syndrome or split cord malformation, in addition to scoliosis. These patients may have a significant curvature of the spine that is causing issues with mobility and function. It is important to carefully assess each patient’s individual situation and determine the best course of treatment to address their specific needs. Monitoring the nervous system during and after surgery is crucial to ensure the best possible outcomes for these patients.

Timeline

Overall, the timeline of a patient’s experience before and after detethering surgery typically involves:

  1. Diagnosis of spinal abnormalities, such as tethered cord syndrome or split cord malformation.
  2. Evaluation by a medical team to determine if detethering surgery is necessary.
  3. Pre-surgical preparations, including imaging tests and consultations with specialists.
  4. Detethering surgery, which may involve adjusting growing rods or other spinal procedures.
  5. Recovery period, which may include physical therapy and monitoring for any complications.
  6. Follow-up appointments to assess the success of the surgery and monitor the patient’s progress.

After detethering surgery, patients may experience improvements in their spinal curvature and overall health, although complications can occur. It is important for patients to follow their medical team’s recommendations for post-operative care and attend regular follow-up appointments to ensure the best possible outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about detethering surgery include:

  1. What is the reason for recommending detethering surgery in my case?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How experienced are you in performing detethering surgeries?
  4. What is the success rate of detethering surgery in patients with spinal abnormalities like mine?
  5. What is the expected recovery time and rehabilitation process after detethering surgery?
  6. Will I need follow-up surgeries or procedures after detethering surgery?
  7. How will my spinal curvature be monitored and managed post-surgery?
  8. What are the alternative treatment options available for my condition?
  9. How will detethering surgery impact my daily activities and quality of life?
  10. Are there any specific precautions or lifestyle changes I need to consider before and after detethering surgery?

Reference

Authors: Jayaswal A, Kandwal P, Goswami A, Vijayaraghavan G, Jariyal A, Upendra BN, Gupta A. Journal: Eur Spine J. 2016 Oct;25(10):3301-3307. doi: 10.1007/s00586-016-4566-5. Epub 2016 Apr 12. PMID: 27072552