Our Summary

This study looked at the results of a specific type of spinal surgery in patients with cerebral palsy (CP). Traditionally, patients with CP who had spinal issues would need two types of fusion surgery for stability. This study, however, looked at the results of a different type of surgery that uses a technique called posterior spinal fusion with cervical pedicle screw constructs.

The researchers looked at 31 CP patients who had this surgery and were followed up for at least two years. They found that, on average, patients’ scores on a scale measuring their condition (the Japanese Orthopaedic Association scoring system) improved significantly after surgery. Also, no patients’ ability to walk got worse after surgery, although 10 were unable to walk at the final check-up. The alignment of patients’ spines was maintained after surgery, and 81% of patients had successful fusion at the final check-up. However, five patients required additional surgery, and five experienced paralysis in the upper body after surgery.

The researchers concluded that this type of surgery is a good option for CP patients, as it has a high success rate and leads to good outcomes. They suggested that future work should focus on improving decision-making about the area to be fused, preventing post-operative paralysis, and simplifying the use of external braces after surgery.

FAQs

  1. What is the posterior spinal fusion with cervical pedicle screw constructs technique?
  2. What were the overall results of the study on spinal fusion surgery in patients with cerebral palsy?
  3. What are some recommendations for future work in spinal fusion surgery for patients with cerebral palsy?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion is to follow post-operative care instructions carefully. This may include avoiding heavy lifting, bending, or twisting for a certain period of time, attending physical therapy sessions as recommended, and maintaining a healthy lifestyle to promote healing and prevent complications. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients with cerebral palsy who have spinal issues are typically recommended spinal fusion surgery to improve stability and alignment of the spine. This study specifically looked at the results of posterior spinal fusion with cervical pedicle screw constructs in CP patients, which was found to be a successful option with positive outcomes. Patients who undergo this type of surgery may experience improvements in their condition, maintenance of spine alignment, and successful fusion of the vertebrae. However, there may be risks such as the need for additional surgery or potential paralysis in some cases. Future research may focus on improving decision-making processes, preventing post-operative complications, and simplifying post-surgery care for CP patients undergoing spinal fusion.

Timeline

Before spinal fusion surgery, a patient with cerebral palsy may experience symptoms such as pain, stiffness, difficulty walking, and spinal deformities. They may undergo various tests and consultations with their medical team to determine if surgery is necessary.

After spinal fusion surgery, the patient will typically experience pain and discomfort at the surgical site, which can be managed with pain medication. They will need to follow a strict rehabilitation program to regain strength and mobility in their spine. Physical therapy and regular follow-up appointments with their healthcare provider will be important in monitoring their progress and ensuring proper healing.

Over time, the patient should see improvements in their symptoms, such as reduced pain and improved spinal alignment. It may take several months to a year for the spine to fully fuse and for the patient to experience the full benefits of the surgery. Follow-up appointments will continue to be important in monitoring the long-term success of the surgery and addressing any potential complications that may arise.

What to Ask Your Doctor

  1. What specific type of spinal fusion surgery do you recommend for my condition, and why?

  2. What are the potential risks and complications associated with spinal fusion surgery?

  3. What is the expected outcome of the surgery in terms of pain relief, mobility, and overall quality of life?

  4. How long is the recovery process after spinal fusion surgery, and what can I expect in terms of post-operative care and rehabilitation?

  5. Will I need to wear a brace or use any assistive devices after surgery, and for how long?

  6. What is the success rate of this type of surgery for patients with my specific condition?

  7. Are there any alternative treatment options to consider before proceeding with spinal fusion surgery?

  8. How often will follow-up appointments be needed after surgery, and what signs should I watch for that may indicate complications?

  9. Will I need physical therapy or other forms of rehabilitation after surgery, and if so, what will that entail?

  10. Are there any lifestyle changes or precautions I should take after spinal fusion surgery to ensure the best possible outcome?

Reference

Authors: Watanabe K, Hirano T, Katsumi K, Ohashi M, Shoji H, Yamazaki A, Izumi T, Hasegawa K, Ito T, Endo N. Journal: Spine (Phila Pa 1976). 2017 Dec 15;42(24):1835-1843. doi: 10.1097/BRS.0000000000002257. PMID: 28574882