Our Summary

This research paper presents a study conducted on children who developed a seroma, which is a pocket of clear serous fluid that sometimes develops in the body after surgery. This particular study focuses on seromas that occurred after spinal deformity surgery.

The researchers reviewed the medical records of patients under 21 years old who had spinal fusion surgery between 1996 and 2016 and developed a seroma afterwards. They excluded patients who had spine growth surgeries or revision procedures.

Out of 790 patients reviewed, 25 developed a seroma. The seromas typically appeared about 13.6 days after surgery and went away on their own after about 12.2 days. The patients were not subjected to any invasive procedures to treat the seromas. If the seroma drained on its own, a sterile dressing was applied and changed as needed until it stopped. A couple of patients had a needle used to aspirate (remove by suction) the fluid, and a few were given antibiotics as a preventive measure.

All the seromas resolved on their own without leading to a serious infection soon after the surgery. However, three patients developed an infection much later, between 18 to 38 months after the surgery. It’s not clear if the seromas contributed to these later infections.

The researchers concluded that taking a conservative approach to managing seromas, meaning not intervening with additional surgery or other invasive procedures, appears to be safe and effective. However, they suggest further study is needed to understand if there’s any connection between seromas and the development of infections much later after surgery.

FAQs

  1. What is a seroma and when does it typically appear after spinal fusion surgery?
  2. How are seromas managed post-surgery and what is the average time for them to resolve on their own?
  3. Is there any connection between the development of seromas and the occurrence of infections after spinal surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal surgery is that while seromas can sometimes develop after the procedure, they typically resolve on their own without the need for invasive treatment. It’s important to follow your doctor’s instructions for wound care and to monitor for any signs of infection. If you have any concerns or notice any unusual symptoms, be sure to contact your healthcare provider for advice.

Suitable For

In general, patients who are recommended for spinal surgery typically have conditions such as:

  1. Spinal deformities: Conditions such as scoliosis, kyphosis, or lordosis that cause abnormal curvature of the spine may require surgical intervention to correct the deformity and prevent further progression.

  2. Degenerative disc disease: This condition occurs when the discs between the vertebrae deteriorate, leading to pain, stiffness, and reduced mobility. Surgery may be recommended to remove the damaged disc and stabilize the spine.

  3. Herniated disc: When the soft inner core of a disc pushes through the tougher outer layer, it can press on nearby nerves and cause pain, numbness, or weakness. Surgery may be necessary to remove the herniated portion of the disc and relieve pressure on the nerves.

  4. Spinal stenosis: This condition occurs when the spinal canal narrows, putting pressure on the spinal cord and nerves. Surgery may be recommended to create more space in the spinal canal and alleviate symptoms.

  5. Spinal fractures: Traumatic injuries to the spine, such as fractures caused by falls or car accidents, may require surgery to stabilize the spine and prevent further damage.

  6. Tumors: Benign or malignant tumors that develop in or around the spine may require surgical removal to prevent compression of the spinal cord or nerves.

It’s important to note that spinal surgery is typically considered a last resort after conservative treatments have been unsuccessful in managing symptoms. The decision to undergo surgery should be made in consultation with a spine specialist who can evaluate the patient’s specific condition and recommend the most appropriate treatment approach.

Timeline

  • Before spinal surgery: The patient typically undergoes a series of consultations with a spine specialist to discuss their condition, potential treatments, and the risks and benefits of surgery. They may also undergo imaging tests such as X-rays, MRIs, and CT scans to further evaluate their condition and help the surgeon plan the procedure.

  • Day of surgery: The patient arrives at the hospital or surgical center and undergoes preoperative preparations, including anesthesia. The surgery itself can vary depending on the specific procedure being performed, but generally involves making an incision in the back, removing damaged or diseased tissue, and stabilizing the spine with hardware such as rods and screws.

  • After surgery: The patient is typically monitored in a recovery area before being transferred to a hospital room or discharged home. They may experience pain, swelling, and limited mobility in the days and weeks following surgery. Physical therapy and rehabilitation are often recommended to help the patient regain strength and function in their spine.

  • In the weeks and months following surgery: The patient continues to follow up with their surgeon for postoperative appointments to monitor their progress and address any concerns. It is important for the patient to follow their surgeon’s instructions for activity restrictions, wound care, and pain management to ensure a successful recovery.

  • Long-term: The patient may experience improvements in their symptoms and quality of life following surgery, but it is important to continue to monitor their spine health and follow up with their surgeon regularly to address any ongoing issues or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery and the potential development of seromas include:

  1. What is a seroma and what are the risk factors for developing one after spinal surgery?
  2. How common is it for patients to develop a seroma after spinal deformity surgery?
  3. How will I know if I have developed a seroma, and what symptoms should I watch out for?
  4. What is the typical course of treatment for a seroma, and will I need any additional procedures or medications?
  5. Are there any complications or long-term effects associated with developing a seroma after spinal surgery?
  6. How likely am I to develop an infection later on if I have had a seroma after surgery?
  7. What steps can I take to prevent the development of a seroma or reduce my risk of complications post-surgery?
  8. Are there any signs or symptoms I should be aware of that could indicate a more serious issue related to the seroma?
  9. How closely will I be monitored for the development of a seroma or any related complications following my surgery?
  10. Are there any specific factors about my individual case that may increase my risk of developing a seroma, and how will these be addressed during the surgical process?

Reference

Authors: Yu J, Dumaine AM, Poe-Kochert C, Thompson GH, Mistovich RJ. Journal: J Pediatr Orthop. 2020 Apr;40(4):e277-e282. doi: 10.1097/BPO.0000000000001496. PMID: 31876697