Our Summary

This study looked at the process of learning and improving in surgeries for severe adolescent scoliosis using a two-surgeon strategy. They looked at 105 patients who had a curvature of their spine (Cobb angle) of 90° or more. They divided the surgeries into three groups based on when they happened and looked at factors like how long the surgery took, how much blood was lost, whether the patient needed a blood transfusion, how long they stayed in the hospital, and any complications that came up during or after the surgery.

They found that the more surgeries the two-surgeon team did, the better they got. By the time they did their 57th surgery, they had significantly improved in terms of time taken and blood loss. So basically, the study found that there’s a learning curve with this type of surgery and that the two-surgeon strategy gets more efficient as they do more surgeries.

FAQs

  1. What was the main focus of the study on severe adolescent scoliosis surgeries?
  2. What factors were looked at in the study of the two-surgeon strategy for scoliosis surgery?
  3. What did the study conclude about the efficiency of the two-surgeon strategy over time?

Doctor’s Tip

A doctor might tell a patient undergoing spinal fusion surgery to choose a medical team that has experience with the procedure, as studies have shown that surgical teams improve in efficiency and outcomes with practice. This can help ensure a smoother and more successful surgery.

Suitable For

Patients who are typically recommended for spinal fusion surgery are those with severe spinal deformities, such as scoliosis, kyphosis, or spondylolisthesis, that have not responded to conservative treatments like physical therapy or bracing. In the case of the study mentioned, patients with a Cobb angle of 90° or more were considered for spinal fusion surgery.

Other factors that may indicate a need for spinal fusion surgery include chronic back pain, instability of the spine, spinal fractures, spinal stenosis, or degenerative disc disease. The decision to recommend spinal fusion surgery is usually made by a team of healthcare professionals, including orthopedic surgeons, neurosurgeons, and physical therapists, based on the individual patient’s condition and symptoms.

Timeline

Before spinal fusion:

  1. Patient consults with a doctor or specialist for evaluation of back pain, deformity, or other spinal issues.
  2. Doctor recommends spinal fusion as a treatment option after conservative methods like physical therapy or medication have been unsuccessful.
  3. Patient undergoes pre-operative testing and preparation, including blood work, imaging scans, and possibly a pre-surgical physical therapy program.
  4. Surgery date is scheduled and patient receives instructions for pre-operative care, such as fasting before surgery.
  5. Patient undergoes spinal fusion surgery, which typically takes several hours and involves fusing together two or more vertebrae using bone grafts and possibly hardware like screws or rods.
  6. Patient is monitored in the hospital for a few days post-surgery to ensure proper healing and manage pain.
  7. Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.

After spinal fusion:

  1. Patient is discharged from the hospital and continues physical therapy and follow-up appointments with their doctor.
  2. Patient may experience pain and discomfort as the spine heals, which can be managed with medications and physical therapy.
  3. Over time, patient gradually resumes normal activities and sees improvement in their symptoms, such as reduced back pain and improved spinal alignment.
  4. Patient continues to follow up with their doctor for monitoring and potential adjustments to their treatment plan.
  5. Long-term outcomes of spinal fusion surgery are monitored to assess the success of the procedure in improving the patient’s quality of life and spinal function.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal fusion surgery?
  2. How long is the recovery process and what can I expect in terms of pain management?
  3. Will I need physical therapy after the surgery and if so, for how long?
  4. How successful is spinal fusion surgery in treating my specific condition?
  5. Are there any alternative treatments or less invasive options available for my condition?
  6. How experienced is the surgical team performing the procedure?
  7. What is the expected outcome in terms of pain relief and improvement in mobility?
  8. Will I need any additional procedures or surgeries in the future?
  9. Are there any restrictions or lifestyle changes I will need to make after the surgery?
  10. What type of follow-up care will be necessary after the surgery?

Reference

Authors: Chan CYW, Lee SY, Ch’ng PY, Chung WH, Chiu CK, Hasan MS, Kwan MK. Journal: Spine (Phila Pa 1976). 2021 Jun 15;46(12):E663-E670. doi: 10.1097/BRS.0000000000003866. PMID: 33306608