Our Summary

This research paper is a look back at a database of patients aged 18 and under who had a specific type of spinal deformity called myelomeningocele (MMC). These patients had surgery to correct the deformity between 2012 and 2018. The aim of the study was to see how many of these patients had complications from the surgery in the first three months after the operation.

The researchers found that most of the patients had surgery to correct scoliosis (a sideways curve of the spine), while a smaller group had surgery for kyphosis (a forward rounding of the back). They also found that using antifibrinolytics (drugs that prevent blood clots from breaking down) reduced the amount of blood lost during surgery.

In some cases, the surgeons also performed a procedure called detethering at the same time, which didn’t seem to increase the rate of complications. However, there were some complications after the surgery, with about a quarter of the patients experiencing issues. These complications included deep wound infections which required further surgery, and one case of a less serious superficial wound infection. They also found that patients who had a drainage time of more than 4 days after surgery were significantly more likely to get a wound infection.

In conclusion, the researchers say that while the surgery is challenging and there are risks, the rate of complications is acceptable, especially when a team with lots of experience is doing the surgery.

FAQs

  1. What is the rate of short-term surgical complications after surgical correction of spine deformities in patients with myelomeningocele?
  2. How does simultaneous detethering affect the rate of short-term surgical complications in patients with myelomeningocele who undergo spine deformity correction surgery?
  3. What factors were found to be significantly associated with wound infection in patients with myelomeningocele who underwent spine deformity correction surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to follow postoperative care instructions carefully to minimize the risk of complications. This may include keeping the surgical site clean and dry, taking prescribed medications as directed, avoiding strenuous activities, and attending follow-up appointments with your healthcare provider. It is also important to report any unusual symptoms or concerns to your doctor promptly.

Suitable For

Patients with myelomeningocele (MMC) who have spine deformities, such as scoliosis, pelvic obliquity, and kyphosis, are typically recommended for detethering surgery. These patients may also have other comorbidities related to their MMC, making the surgical treatment challenging. In this study, patients aged ≤ 18 years who underwent spine deformity correction surgery between 2012 and 2018 were included. The study found that the rate of short-term surgical complications in these patients was acceptable with a multidisciplinary approach and extensive experience in spine deformity surgery. Detethering surgery was performed in some patients simultaneously with spine deformity correction, and it was not associated with higher complication rates. Drainage time longer than 4 days was significantly associated with wound infection, highlighting the importance of postoperative care in reducing complications.

Timeline

  • Patient is diagnosed with myelomeningocele and spine deformities
  • Patient undergoes preoperative evaluation and planning for spine deformity correction surgery
  • Patient undergoes detethering surgery along with spine deformity correction if indicated
  • In the 3-month postoperative period, patient is monitored for short-term surgical complications
  • Patient may experience complications such as wound infections, which may require surgical debridement
  • Drainage time longer than 4 days is significantly associated with wound infection
  • Multidisciplinary approach is used to manage complications and improve outcomes

What to Ask Your Doctor

  1. What is the success rate of detethering surgery in patients with myelomeningocele?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How long is the recovery process following detethering surgery?
  4. Will physical therapy or rehabilitation be necessary after the surgery?
  5. How long will I need to stay in the hospital after detethering surgery?
  6. Are there any long-term effects or complications I should be aware of?
  7. What is the expected outcome or prognosis following detethering surgery?
  8. Will I need to undergo any additional surgeries or treatments in the future?
  9. How experienced is the surgical team in performing detethering surgery for myelomeningocele patients?
  10. Are there any alternative treatment options available for my condition?

Reference

Authors: de Araújo AO, Gomes CR, Fava D, Borigato EVM, Duarte LMR, de Oliveira RG. Journal: Spine Deform. 2021 Jul;9(4):1151-1159. doi: 10.1007/s43390-021-00304-8. Epub 2021 Feb 23. PMID: 33620695