Our Summary

This study looks at the best way to operate on children with early onset scoliosis (a curvature of the spine which starts at a young age) and a condition where the spinal cord is held too tightly (tethered spinal cord). The researchers wanted to know if it was better to do two separate operations to fix these problems, or if it was better to do both in one go.

They looked at a group of patients who all had these conditions and split them into two groups. The first group had both procedures done at the same time whilst under anesthesia, and the second group had the procedures done on separate occasions.

The findings showed that the amount of spine straightening after surgery was about the same in both groups. However, the group that had the two surgeries done at the same time had no complications, while some patients in the other group had complications after their surgeries.

Based on these results, the researchers suggest that doing both surgeries at the same time could be a better approach as it appears to be safe and might carry less risk of complications than doing the two surgeries separately. This study is the largest of its kind so far comparing the two surgical methods.

FAQs

  1. What conditions were the focus of this study on detethering surgery?
  2. Did the study find any benefits of doing both surgeries at the same time rather than separately?
  3. What were the complications observed among the group of patients who had the surgeries done separately?

Doctor’s Tip

A helpful tip a doctor might give a patient about detethering surgery is to consider having both the detethering surgery and any other necessary spine procedures done at the same time, as this may reduce the risk of complications and potentially provide better outcomes. It is important to discuss this option with your surgeon to determine the best course of action for your individual situation.

Suitable For

Patients who are typically recommended detethering surgery are those with early onset scoliosis and a tethered spinal cord. These patients may experience symptoms such as back pain, leg weakness, difficulty walking, and abnormal curvature of the spine. The decision to undergo detethering surgery is typically made based on the severity of symptoms and the potential for improvement in quality of life and function following the procedure.

Timeline

Before detethering surgery, a patient may experience symptoms such as back pain, leg weakness, difficulty walking, and bladder or bowel dysfunction. They may undergo imaging tests such as MRI to diagnose the tethered spinal cord and scoliosis. The patient will meet with a neurosurgeon and orthopedic surgeon to discuss the surgery and potential risks and benefits.

After detethering surgery, the patient will be monitored closely in the hospital for a few days to ensure there are no complications. They may experience some pain and discomfort at the surgical site. Physical therapy may be recommended to help with recovery and regain strength and mobility. The patient will have follow-up appointments with their surgical team to monitor their progress and address any concerns. Over time, the patient should experience improvement in their symptoms and overall quality of life.

What to Ask Your Doctor

  1. What is detethering surgery and how does it help with conditions such as early onset scoliosis and tethered spinal cord?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How will the decision be made whether to do both surgeries at the same time or on separate occasions?
  4. What is the recovery process like after detethering surgery?
  5. Are there any long-term effects or considerations to keep in mind after undergoing detethering surgery?
  6. How experienced is the surgical team in performing detethering surgery?
  7. What is the success rate for this type of surgery in patients with similar conditions?
  8. Are there any alternative treatment options to consider before undergoing detethering surgery?
  9. What type of follow-up care or monitoring will be needed after the surgery?
  10. Are there any lifestyle changes or precautions that should be taken post-surgery to ensure optimal recovery?

Reference

Authors: Kunes J, Quan T, Iyer R, Fano AN, Matsumoto H, Erickson M, McCarthy R, Brockmeyer D, Anderson RCE, Vitale MG; Pediatric Spine Study Group. Journal: Spine Deform. 2022 Nov;10(6):1473-1480. doi: 10.1007/s43390-022-00550-4. Epub 2022 Jul 12. PMID: 35821353