Our Summary

This research paper is about a study that looked at how effectively a modified version of the Clavien-Dindosink (CDS) classification system could be used to describe complications after a specific type of spine surgery (posterior spinal fusion) in patients with adolescent idiopathic scoliosis (AIS). The CDS system is a tool that provides more detailed information about treatment than other methods of describing surgical complications. The researchers added “prolonged initial hospital stay” as a criterion to the CDS system for this study.

The researchers used a large international database to review all complications specific to AIS patients. They then asked nine spinal surgeons to review and grade these complications using the modified CDS system. The researchers also asked the surgeons to grade 20 clinical scenarios.

The results showed that the modified CDS system was very reliable when used by different surgeons (interrater reliability) and by the same surgeon at different times (intrarater reliability). The researchers conclude that the modified CDS system could be a valuable tool for reporting outcomes and improving surgical practices and patient outcomes.

FAQs

  1. What is the Clavien-Dindosink (CDS) classification system and how was it modified for this study?
  2. How did the researchers determine the reliability of the modified CDS system in the study?
  3. How could the modified CDS system potentially improve surgical practices and patient outcomes according to the researchers?

Doctor’s Tip

One helpful tip a doctor might tell a patient about spinal fusion is to follow post-operative instructions carefully, including physical therapy exercises and restrictions on activities, to promote proper healing and reduce the risk of complications. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients with adolescent idiopathic scoliosis (AIS) who undergo posterior spinal fusion are typically recommended spinal fusion surgery. AIS is a common type of scoliosis that occurs in adolescents and is characterized by a curvature of the spine. Spinal fusion surgery is often recommended for patients with AIS who have a spinal curvature that is severe or progressive, causing pain or affecting their ability to function normally.

In addition to AIS patients, spinal fusion surgery may also be recommended for patients with other spinal conditions, such as degenerative disc disease, spinal stenosis, spondylolisthesis, or spinal fractures. These conditions may cause instability in the spine, leading to pain, nerve compression, or other symptoms that can be improved with spinal fusion surgery.

Overall, patients who are experiencing debilitating symptoms related to a spinal condition that has not responded to conservative treatments may be recommended spinal fusion surgery. It is important for patients to discuss their specific condition and treatment options with their healthcare provider to determine if spinal fusion surgery is the best course of action for their individual situation.

Timeline

Before spinal fusion surgery:

  1. Patient undergoes initial consultation with a spine surgeon to discuss treatment options for their condition.
  2. Patient undergoes pre-operative testing and evaluations to ensure they are a suitable candidate for surgery.
  3. Patient may undergo physical therapy or other conservative treatments to prepare for surgery.
  4. Patient is admitted to the hospital on the day of surgery and undergoes the procedure.

After spinal fusion surgery:

  1. Patient is closely monitored in the hospital for complications and to manage pain.
  2. Patient may experience post-operative pain and discomfort, which is managed with medication.
  3. Patient begins physical therapy and rehabilitation to regain strength and mobility.
  4. Patient is discharged from the hospital once they are stable and able to care for themselves at home.
  5. Patient continues physical therapy and follow-up appointments with their surgeon to monitor their progress.
  6. Patient gradually returns to normal activities and may experience improved quality of life and reduced pain.

What to Ask Your Doctor

  1. Can you explain the specific risks and potential complications associated with spinal fusion surgery for my condition?

  2. How long is the recovery process expected to be after spinal fusion surgery?

  3. Will I need physical therapy or rehabilitation after the surgery, and if so, for how long?

  4. Are there any alternative treatments to spinal fusion that I should consider?

  5. How many spinal fusion surgeries have you performed, and what is your success rate with this procedure?

  6. What is the expected outcome or prognosis for my specific case after spinal fusion surgery?

  7. Will I need to follow any specific post-operative care instructions or restrictions after the surgery?

  8. What is the likelihood of needing additional surgeries or interventions in the future after spinal fusion surgery?

  9. How long can I expect the hardware or implants used in the surgery to last?

  10. Are there any lifestyle changes or modifications I should make after spinal fusion surgery to prevent complications or promote healing?

Reference

Authors: Guissé NF, Stone JD, Keil LG, Bastrom TP, Erickson MA, Yaszay B, Cahill PJ, Parent S, Gabos PG, Newton PO, Glotzbecker MP, Kelly MP, Pahys JM, Fletcher ND. Journal: Spine Deform. 2022 Jan;10(1):87-95. doi: 10.1007/s43390-021-00394-4. Epub 2021 Aug 5. PMID: 34351605