Our Summary

The research paper is about how to prevent complications after surgery for adult spinal deformity (ASD). Sometimes, after these kinds of surgeries, the wound doesn’t heal properly, which can cause it to reopen or become infected. One way to prevent this is by using a technique where a local muscle flap is used to cover the wound.

In this study, the authors looked back at the medical records of patients who underwent ASD surgery. They compared two groups: one where the wound was closed by a neurosurgeon and another where the wound was closed by a plastic surgeon.

They found out that patients who had their wounds closed by a plastic surgeon were generally at a higher risk of complications. However, when they compared similar risk levels, they found that patients attended by plastic surgeons had fewer wound complications and wounds reopening compared to those closed by neurosurgeons.

So, the authors concluded that involving a plastic surgeon in the wound closure process after ASD surgery might help reduce the risk of wound complications in patients who are at a higher risk. They suggest that a team approach, involving both plastic and spine surgeons, could be the best way to handle these high-risk cases.

FAQs

  1. What is the purpose of the research paper about spinal surgery?
  2. What were the findings when comparing patients whose wounds were closed by a neurosurgeon versus those closed by a plastic surgeon?
  3. What is the authors’ conclusion about the best approach for wound closure following adult spinal deformity surgery?

Doctor’s Tip

A doctor might tell a patient undergoing spinal surgery to follow post-operative care instructions carefully, including keeping the wound clean and dry, avoiding strenuous activities, and attending follow-up appointments. Additionally, they might advise the patient to discuss the possibility of involving a plastic surgeon in the wound closure process to help reduce the risk of complications.

Suitable For

Patients who are typically recommended for spinal surgery include those with adult spinal deformity, spinal stenosis, herniated discs, scoliosis, spinal fractures, spinal tumors, and other conditions that cause severe back pain, nerve compression, or spinal instability. These patients may have tried conservative treatments such as physical therapy, medications, and injections without success, and may be experiencing symptoms that significantly impact their quality of life.

Patients who are considering spinal surgery should undergo a thorough evaluation by a spine specialist to determine if surgery is the best treatment option for their specific condition. Factors such as the severity of the spinal deformity, the presence of neurological symptoms, the patient’s overall health and medical history, and their willingness to participate in post-operative rehabilitation are all taken into consideration when determining if spinal surgery is appropriate for a patient.

Ultimately, the decision to undergo spinal surgery is made on a case-by-case basis, taking into account the individual patient’s unique circumstances and goals for treatment.

Timeline

Before spinal surgery:

  • Patient undergoes a thorough evaluation and diagnostic testing to determine the need for surgery
  • Patient meets with the surgeon to discuss the procedure, potential risks, and expected outcomes
  • Patient may undergo preoperative preparation, which may include blood tests, imaging scans, and medication adjustments
  • Surgery is scheduled and patient receives instructions on preoperative care and what to expect during and after surgery

After spinal surgery:

  • Patient is closely monitored in the recovery room for any immediate postoperative complications
  • Patient is transferred to a hospital room or discharged home, depending on the complexity of the surgery
  • Patient may experience pain, swelling, and discomfort in the days following surgery
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility
  • Patient attends follow-up appointments with the surgeon to monitor healing and address any concerns
  • Patient gradually resumes normal activities and may require ongoing care and monitoring for long-term outcomes and potential complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with spinal surgery for adult spinal deformity (ASD)?
  2. How can the risk of wound complications, such as reopening or infection, be minimized after surgery?
  3. Can involving a plastic surgeon in the wound closure process help reduce the risk of complications?
  4. What is the difference between having the wound closed by a neurosurgeon versus a plastic surgeon?
  5. Are there any specific criteria or factors that would determine whether a plastic surgeon should be involved in the wound closure process?
  6. How does a team approach involving both plastic and spine surgeons benefit high-risk patients undergoing ASD surgery?
  7. What post-operative care measures can be taken to promote proper wound healing and reduce the risk of complications?
  8. How long does the recovery process typically take after spinal surgery for ASD, and what can I expect during this time?
  9. Are there any lifestyle modifications or activities that should be avoided during the recovery period to prevent complications?
  10. What are the signs and symptoms of a potential wound complication that I should watch out for, and when should I contact my healthcare provider?

Reference

Authors: Gadot R, Anand A, Verla T, Muir M, Winocour SJ, Reece EM, Ropper AE. Journal: World Neurosurg. 2022 Jun;162:e561-e567. doi: 10.1016/j.wneu.2022.03.057. Epub 2022 Mar 21. PMID: 35331948