Our Summary

This research study compares two types of surgery used to treat long-spanned congenital scoliosis (a curvature of the spine present from birth) in children aged 9 to 11. The first type of surgery is known as a growth-friendly technique, which involves using rods and screws to help guide the growth of the spine. The second type is posterior spinal fusion, where the surgeon fuses the vertebrae together to correct the curve.

Between 2009 and 2017, 212 patients aged between 9 and 11 underwent one of these two surgeries at a single spinal center. The researchers noted how well each type of surgery corrected the spinal curvature, how many surgical complications occurred, and whether the surgeries improved quality of life and lung function.

The study found that posterior spinal fusion provided better correction of the spinal curvature and had fewer complications than the growth-friendly technique. There were no significant differences in lung function between the two groups. However, quality of life, as reported by both patients and parents, was better in the group that underwent posterior spinal fusion.

The researchers concluded that posterior spinal fusion may be a better option than the growth-friendly technique for children aged 9 to 11 with long-spanned congenital scoliosis, especially if there is limited growth potential in the area to be operated on. However, this is a level III study, meaning that while the results are based on a relatively large number of patients, they haven’t been confirmed by multiple high-quality studies yet.

FAQs

  1. What are the two types of surgery compared in this research study for treating long-spanned congenital scoliosis?
  2. Which surgical technique was found to provide better correction of the spinal curvature and fewer complications?
  3. What does it mean that this is a level III study and how does it affect the conclusions drawn from the results?

Doctor’s Tip

A doctor might tell a patient considering spinal fusion surgery that it is important to carefully weigh the risks and benefits of the procedure. They may explain that while spinal fusion can provide better correction of spinal curvature and potentially improve quality of life, it is important to understand that there may be risks and complications associated with the surgery. It is important to have a thorough discussion with the surgeon about the potential outcomes and to ask any questions or voice any concerns before making a decision.

Suitable For

Patients who are typically recommended spinal fusion surgery include those with severe spinal deformities such as scoliosis, kyphosis, or spondylolisthesis that have not responded to non-surgical treatments. Spinal fusion may also be recommended for patients with spinal instability, degenerative disc disease, spinal tumors, or spinal fractures. Additionally, patients with certain neurological conditions such as spinal stenosis or spinal cord compression may benefit from spinal fusion surgery. Ultimately, the decision to undergo spinal fusion surgery is made on a case-by-case basis by a team of healthcare professionals including orthopedic surgeons, neurosurgeons, and physical therapists.

Timeline

Before spinal fusion surgery, a patient may experience chronic back pain, limited mobility, difficulty breathing, and other symptoms related to their spinal condition. They may have undergone non-surgical treatments such as physical therapy or bracing to manage their symptoms.

After spinal fusion surgery, a patient can expect a period of recovery that includes pain management, physical therapy, and restrictions on activities like bending or lifting. Over time, the patient should experience improved spinal alignment, reduced pain, and increased mobility as the fused vertebrae heal and stabilize. In the long term, the patient may have improved quality of life and functional ability, although they may still need to follow up with their healthcare provider for monitoring and ongoing care.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion include:

  1. What are the potential risks and complications associated with spinal fusion surgery?
  2. How long is the recovery process after spinal fusion surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. What type of anesthesia will be used during the surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. Will I need to wear a brace or use any assistive devices after the surgery?
  7. What are the long-term effects of spinal fusion surgery?
  8. Will I be able to return to my normal activities after the surgery?
  9. Are there any alternative treatments or surgical techniques that could be considered for my condition?
  10. How often will I need follow-up appointments after the surgery?

Reference

Authors: Xu L, Sun X, Du C, Zhou Q, Shi B, Zhu Z, Qiu Y. Journal: Clin Orthop Relat Res. 2020 Oct;478(10):2375-2386. doi: 10.1097/CORR.0000000000001377. PMID: 32568886