Our Summary

This paper reviews the long-term results of surgical treatments for adolescent idiopathic scoliosis (AIS), a common spinal deformity in young people. The authors looked at the outcomes of spinal fusion, a surgical procedure where some vertebrae are permanently joined together. They found that over time, the management of AIS has improved, but the long-term outcomes are not as good as those seen in people without this condition. One common issue after surgery is adjacent degenerations, where the parts of the spine above and below the surgical site start to deteriorate, although it’s unclear how this affects the overall outcome. The authors also noted a slightly higher rate of cesarean sections in women who had undergone this surgery, possibly due to changes in the spine’s shape. However, they concluded that there is a lack of high-quality, long-term data on AIS and its treatment.

FAQs

  1. What is adolescent idiopathic scoliosis (AIS) and how is it managed surgically?
  2. What are some of the common issues that occur after spinal fusion surgery for AIS?
  3. Has there been any observed correlation between spinal fusion surgery and higher rates of cesarean sections in women?

Doctor’s Tip

One helpful tip a doctor might give a patient about spinal fusion is to follow a comprehensive rehabilitation program after surgery. This may include physical therapy, strengthening exercises, and proper body mechanics to help support the spine and prevent future complications. It’s important to listen to your healthcare team’s recommendations and take an active role in your recovery to ensure the best possible outcome. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can also support the healing process and overall spinal health.

Suitable For

Patients who are typically recommended spinal fusion include those with severe spinal deformities such as scoliosis, kyphosis, or spondylolisthesis that have not responded to conservative treatments such as physical therapy or bracing. Other conditions that may warrant spinal fusion include degenerative disc disease, spinal stenosis, spinal fractures, or tumors in the spine. Additionally, patients with spinal instability or significant spinal trauma may also benefit from spinal fusion surgery. It is important for patients to discuss their individual circumstances with a spine specialist to determine if spinal fusion is the most appropriate treatment option for their condition.

Timeline

Before spinal fusion:

  1. Patient is diagnosed with adolescent idiopathic scoliosis (AIS), a common spinal deformity in young people.
  2. Patient undergoes various non-surgical treatments such as bracing, physical therapy, and monitoring of the curve progression.
  3. As the curvature of the spine worsens and causes pain or other symptoms, the patient and their healthcare team may decide that surgical intervention, such as spinal fusion, is necessary.

After spinal fusion:

  1. Patient undergoes spinal fusion surgery, where some vertebrae are permanently joined together to correct the curvature of the spine.
  2. Patient experiences a recovery period in the hospital and at home, including pain management, physical therapy, and restrictions on activities.
  3. Over time, the patient may experience improvements in their symptoms and spine alignment, but may also develop adjacent degeneration of the spine above and below the surgical site.
  4. Long-term outcomes of spinal fusion for AIS may include a slightly higher rate of cesarean sections in women who have undergone the surgery, as well as a lack of high-quality, long-term data on the overall effectiveness of the treatment.

What to Ask Your Doctor

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

  2. What is the expected recovery time and rehabilitation process after spinal fusion surgery?

  3. How will spinal fusion surgery affect my daily activities, such as work, exercise, and hobbies?

  4. Will I need to follow any specific post-operative care instructions or restrictions?

  5. Are there any alternative treatment options to spinal fusion surgery that I should consider?

  6. How likely am I to experience adjacent degenerations or other long-term complications after spinal fusion surgery?

  7. Will I need additional surgeries or treatments in the future to address any issues that may arise from spinal fusion surgery?

  8. How will spinal fusion surgery affect my overall quality of life in the long term?

  9. Are there any specific lifestyle changes or modifications I should make to support my recovery after spinal fusion surgery?

  10. Can you provide me with information on the success rates and outcomes of spinal fusion surgery for patients with my specific condition or circumstances?

Reference

Authors: Pishnamaz M, Migliorini F, Blume C, Kobbe P, Trobisch P, Delbrück H, Hildebrand F, Herren C. Journal: Eur J Med Res. 2024 Nov 5;29(1):534. doi: 10.1186/s40001-024-02052-7. PMID: 39497199