Our Summary

Scoliosis, a condition that causes a curve in the spine, is a common issue for people with neuromuscular disorders. Treating this condition can be difficult, and when surgery is used, there is a high risk of complications. Recent studies have shown that the rates of these complications can vary greatly, from 6.3% to 75%, depending on the patient’s specific condition and where they received treatment.

However, for patients who make it through the surgery without major complications, there is evidence that their overall health and life expectancy can improve. To ensure the best possible outcome, it is essential to prepare the patients properly before the operation.

The most common complications are related to the lungs, with up to 29% of patients experiencing such issues. Therefore, it’s crucial to optimize the patients’ lung health before the operation. The next most common complications involve the surgical implants, with up to 23% of patients having complications that may require another surgery. To minimize these risks, it’s important to ensure optimal bone health before surgery.

While complications related to the nervous system and heart are less common, they can be very serious. Understanding each patient’s specific condition and potential risks can help prevent these complications.

This paper summarizes a course on the treatment of scoliosis in patients with neuromuscular disorders, providing recommendations from some of the world’s leading experts in the field.

FAQs

  1. What are the common complications of scoliosis surgery in patients with neuromuscular disorders?
  2. How can complications from scoliosis surgery be minimized or prevented?
  3. How can scoliosis surgery affect the overall health and life expectancy of patients with neuromuscular disorders?

Doctor’s Tip

One helpful tip a doctor might tell a patient about detethering surgery is to make sure to follow all pre-operative instructions provided by the medical team. This may include optimizing lung health, bone health, and overall physical condition before the surgery. It is also important to discuss any potential risks or concerns with the medical team and ask any questions to ensure a clear understanding of the procedure and expected outcomes. Additionally, following post-operative care instructions and attending all follow-up appointments is crucial for a successful recovery.

Suitable For

Patients with neuromuscular disorders, such as cerebral palsy, spina bifida, muscular dystrophy, and spinal cord injuries, are typically recommended detethering surgery if they have developed spinal cord tethering. This condition occurs when the spinal cord becomes attached to surrounding tissues, limiting its ability to move and causing symptoms such as pain, weakness, and loss of sensation.

Detethering surgery is recommended for patients who have symptoms that are impacting their quality of life and function, such as difficulty walking, bowel or bladder dysfunction, or progressive spinal deformities. In some cases, detethering surgery may also be recommended as a preventive measure to reduce the risk of further neurological deterioration.

It is important for patients with neuromuscular disorders who are considering detethering surgery to undergo a thorough evaluation by a multidisciplinary team of healthcare professionals, including neurosurgeons, orthopedic surgeons, and rehabilitation specialists. This team can assess the patient’s individual needs and risks, develop a comprehensive treatment plan, and provide support throughout the surgical process and recovery.

Overall, detethering surgery can be a beneficial treatment option for patients with neuromuscular disorders who are experiencing symptoms related to spinal cord tethering. By working closely with a knowledgeable healthcare team and following recommended guidelines for preoperative preparation and postoperative care, patients can improve their overall health and quality of life.

Timeline

Before detethering surgery:

  • Patient is diagnosed with scoliosis, a condition causing a curve in the spine
  • Patient undergoes pre-operative evaluations to assess their overall health and specific condition
  • Patient may need to optimize lung health and bone health to minimize risks of complications
  • Patient and their medical team discuss the potential risks and benefits of surgery
  • Surgery is scheduled and patient prepares for the procedure

After detethering surgery:

  • Patient undergoes the surgical procedure to detether the spine
  • Patient is monitored closely in the immediate post-operative period for any complications
  • Patient may need to stay in the hospital for a period of time for recovery
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Patient follows up with their medical team for ongoing monitoring and care

Overall, detethering surgery can lead to improved health and quality of life for patients with scoliosis and neuromuscular disorders, but it is important to carefully consider the potential risks and take steps to minimize them before and after the procedure.

What to Ask Your Doctor

  1. What specific risks and complications are associated with detethering surgery for my condition?

  2. How will you assess my lung health before the surgery to minimize the risk of complications?

  3. What steps will be taken to optimize my bone health before the operation to reduce the risk of implant-related complications?

  4. Can you explain the potential risks related to the nervous system and heart during detethering surgery for my specific condition?

  5. What is your experience with performing detethering surgery on patients with neuromuscular disorders, and what is your success rate in minimizing complications?

  6. Are there any alternative treatment options available for my condition, and what are the potential risks and benefits of each option?

  7. How long is the recovery process expected to be after detethering surgery, and what kind of post-operative care will be necessary to ensure a successful outcome?

  8. What kind of follow-up care and monitoring will be required after the surgery to address any potential complications or issues that may arise?

  9. Can you provide me with information on the long-term effects of detethering surgery on overall health and life expectancy for patients with neuromuscular disorders?

  10. Are there any specific lifestyle changes or precautions I should take before and after detethering surgery to minimize the risk of complications and promote a successful recovery?

Reference

Authors: Welborn MC, Redding G, Evers P, Nicol L, Bauer DF, Iyer RR, Poon S, Hwang S. Journal: Spine Deform. 2024 Jul;12(4):867-876. doi: 10.1007/s43390-024-00865-4. Epub 2024 Apr 18. PMID: 38634998