Our Summary

This research paper is about a study conducted on 80 patients who underwent surgery for adult spine deformity. The surgery involved long fusion to the sacrum with iliac screws. The researchers were interested in understanding how this type of surgery impacts the structure of the pelvis and a specific measure called the pelvic incidence (PI).

Before and after the surgery, the researchers took X-rays and CT scans of the patients’ pelvis. They then measured and compared the PI and other relevant measurements. They found that after the surgery, the PI significantly decreased and the distance between the two prominent bones at the back of the pelvis (posterior superior iliac spines) significantly increased. They also found that the angle of the iliac (a part of the pelvis) significantly decreased.

The changes in PI were found to be related to the changes in the iliac angle and the distance between the posterior superior iliac spines. This suggests that the movement of the sacroiliac joint (a joint in the lower part of the spine that connects the spine to the pelvis) during surgery can influence the overall structure of the pelvis.

In conclusion, the researchers suggest that surgeons should consider the potential movement of the sacroiliac joint when selecting the type of surgery and the placement of screws in the pelvis for patients with adult spine deformity.

FAQs

  1. What was the focus of the research study on patients who underwent surgery for adult spine deformity?
  2. What changes were observed in the structure of the pelvis and the pelvic incidence (PI) after the surgery?
  3. What was the conclusion of the researchers about the influence of the movement of the sacroiliac joint during surgery on the overall structure of the pelvis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal fusion is to follow post-operative instructions carefully, including proper wound care, physical therapy exercises, and restrictions on certain activities to ensure proper healing and a successful outcome. It is also important to attend follow-up appointments with your healthcare provider to monitor your progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended spinal fusion include those with severe back pain and instability of the spine due to conditions such as degenerative disc disease, scoliosis, spinal stenosis, spondylolisthesis, or spinal fractures. Spinal fusion may also be recommended for patients who have not found relief from conservative treatments such as physical therapy, medication, or injections. Additionally, patients with spinal deformities or abnormalities that are causing neurological symptoms or impairing daily function may also be candidates for spinal fusion surgery.

Timeline

Timeline:

Before surgery:

  • Patient undergoes pre-operative assessments, including physical examinations, X-rays, CT scans, and other diagnostic tests to determine the extent of the spine deformity and plan for the surgery.
  • Patient meets with their surgeon to discuss the procedure, potential risks, benefits, and post-operative care.
  • Patient may undergo physical therapy or other treatments to prepare for surgery.
  • Patient may need to make lifestyle changes, such as quitting smoking or losing weight, to optimize surgical outcomes.

During surgery:

  • Surgeon performs the spinal fusion surgery, which involves connecting two or more vertebrae together using bone grafts, screws, rods, or plates to stabilize the spine and reduce pain.
  • Surgeon may also perform additional procedures, such as decompression or correction of spinal deformities, depending on the patient’s condition.
  • Surgery typically lasts several hours, and the patient is placed under general anesthesia.

After surgery:

  • Patient is monitored in the recovery room before being transferred to a hospital room for post-operative care.
  • Patient may experience pain, swelling, and limited mobility in the days following surgery.
  • Patient is encouraged to walk and perform gentle exercises to aid in recovery and prevent complications such as blood clots or pneumonia.
  • Patient may need to wear a back brace or undergo physical therapy to help support the spine and regain strength and flexibility.
  • Patient will have follow-up appointments with their surgeon to monitor their progress and address any concerns or complications.
  • Over time, the patient’s spine will fuse together, and they will gradually return to their normal activities with reduced pain and improved function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal fusion, especially in the context of adult spine deformity and long fusion to the sacrum with iliac screws, include:

  1. What specific changes can I expect in the structure of my pelvis after undergoing spinal fusion surgery?
  2. How will the surgery impact my pelvic incidence (PI) and other relevant measurements?
  3. Will the movement of the sacroiliac joint be taken into consideration during the surgery? How will this influence the overall structure of my pelvis?
  4. What are the potential risks or complications associated with changes in the pelvic structure post-surgery?
  5. How will the placement of screws in my pelvis affect my long-term outcomes and quality of life?
  6. Are there alternative surgical techniques or approaches that could minimize changes in the pelvic structure?
  7. What is the expected recovery process and timeline following spinal fusion surgery, specifically in relation to the pelvis?
  8. How will changes in the pelvic structure impact my mobility, comfort, and overall function post-surgery?
  9. Are there any specific post-operative exercises or physical therapy recommendations to help maintain pelvic alignment and function?
  10. What long-term monitoring or follow-up care will be needed to assess the impact of the surgery on my pelvic structure and overall spinal health?

Reference

Authors: Oba H, Ebata S, Takahashi J, Ikegami S, Koyama K, Kato H, Haro H, Ohba T. Journal: Eur Spine J. 2019 Sep;28(9):2103-2111. doi: 10.1007/s00586-019-06027-9. Epub 2019 Jun 21. PMID: 31227970