Our Summary

This research examined trends in spinal fusion surgery for patients with Neurofibromatosis type I (NF-1), a genetic disorder that causes tumors to form on nerve tissue. The study looked at 548 patients who had this surgery between 2003 and 2014. The researchers compared three types of spinal fusion surgery: posterior spinal fusion (PSF), anterior-posterior spinal fusion (APSF), and anterior spinal fusion (ASF).

The study found that the number of spinal fusion surgeries for NF-1 patients increased significantly over the study period. PSF surgeries became nearly three times more common, while APSF surgeries became less than half as common. The type of surgery chosen also tended to be influenced by the location of the spinal deformation.

Interestingly, the study found that patients undergoing APSF were significantly younger than those having the other types of surgery. APSF was also associated with longer hospital stays and higher costs. In fact, APSF was the most expensive type of surgery, costing on average $180,714, compared to $144,027 for PSF and $105,312 for ASF.

In conclusion, it’s clear that the surgical treatment approach for NF-1 has shifted over the years and varies depending on the location of the deformity. The study also highlights the significant cost and hospitalization differences between surgical methods.

FAQs

  1. Has the frequency of spinal fusion surgeries for patients with Neurofibromatosis type I (NF-1) increased over time?
  2. How does the type of spinal fusion surgery chosen for NF-1 patients relate to the location of the spinal deformation?
  3. What are the cost and hospitalization differences between the three types of spinal fusion surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion is to thoroughly discuss the different types of surgery options available, including the potential risks and benefits of each, before making a decision. It’s important to understand the specific factors that may influence the choice of surgery, such as the location of the spinal deformation and the patient’s age. Additionally, patients should be aware of the potential costs and length of hospital stay associated with each type of surgery. Ultimately, working closely with your medical team to make an informed decision is key to achieving the best outcome.

Suitable For

Overall, patients with Neurofibromatosis type I who have spinal deformities that are causing symptoms such as pain, weakness, or difficulty walking are typically recommended spinal fusion surgery. The decision on the type of surgery to undergo depends on various factors such as the location and severity of the deformity, the patient’s age, and overall health status.

Patients with other conditions such as scoliosis, degenerative disc disease, spinal stenosis, or spinal fractures may also be recommended spinal fusion surgery if conservative treatments have failed to provide relief. Additionally, patients with conditions such as spinal tumors, infections, or traumatic injuries may also require spinal fusion surgery to stabilize the spine and alleviate symptoms.

Ultimately, the decision to undergo spinal fusion surgery should be made in consultation with a spine specialist who can evaluate the individual patient’s condition and determine the most appropriate treatment plan.

Timeline

Before spinal fusion surgery, a patient typically experiences chronic back pain, numbness or weakness in the legs, difficulty walking or standing, and limited range of motion in the spine. They may have tried conservative treatments such as physical therapy, medication, or injections without success.

After spinal fusion surgery, the patient will undergo a period of recovery and rehabilitation. This may include staying in the hospital for a few days to a week, followed by several weeks of limited activity and physical therapy. Over time, the patient should experience relief from their previous symptoms and improved spinal stability. They may also need to make lifestyle changes to maintain the success of the surgery, such as avoiding heavy lifting or high-impact activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion surgery for NF-1 include:

  1. What type of spinal fusion surgery do you recommend for my specific condition?
  2. How will the location of my spinal deformity impact the type of surgery and overall outcome?
  3. What are the potential risks and complications associated with each type of spinal fusion surgery?
  4. How long is the recovery process for each type of surgery, and what can I expect in terms of pain management and rehabilitation?
  5. Are there any alternative treatment options to consider before undergoing spinal fusion surgery?
  6. What are the success rates for each type of spinal fusion surgery in patients with NF-1?
  7. How will you monitor my progress after surgery, and what signs should I watch for that may indicate a complication?
  8. What are the expected costs associated with each type of spinal fusion surgery, including hospitalization and post-operative care?
  9. Can you provide me with information about your experience and success rates in performing spinal fusion surgery for patients with NF-1?
  10. Are there any lifestyle changes or precautions I should take after undergoing spinal fusion surgery?

Reference

Authors: Kurucan E, Bernstein DN, Thirukumaran C, Jain A, Menga EN, Rubery PT, Mesfin A. Journal: Spine Deform. 2018 Nov-Dec;6(6):712-718. doi: 10.1016/j.jspd.2018.03.012. PMID: 30348349