Our Summary

This research paper is a review of previous surgeries performed on children and young adults with severe spinal deformities. The researchers wanted to compare the outcomes and complications of two types of surgery: one where only one part of the spine was operated on (single-level VCR), and one where multiple parts were operated on (multilevel VCR).

They looked at the records of 82 patients who had a VCR surgery performed by the same surgeon between 2002 and 2012. Of these, 45 had a single-level VCR and 37 had a multilevel VCR.

The results showed that there was no difference in how well the surgeries corrected the spinal deformities. However, the single-level surgeries were quicker. Also, while the amount of blood loss during surgery was similar in both groups, there were more instances of spinal cord monitoring events (which can indicate potential issues) in the group who had multilevel surgery. Importantly, none of the patients who had a single-level VCR had any postoperative neurologic deficits (problems with nerve function after surgery), while three patients who had a multilevel VCR did, although these were temporary.

Based on these results, the researchers suggest that single-level VCR surgeries should be the first choice unless there’s a specific reason to do a multilevel resection, such as the need to relieve pressure on the spinal cord.

FAQs

  1. What is the difference between single-level VCR and multilevel VCR surgeries?
  2. What were the main findings of this research on surgeries for severe spinal deformities?
  3. What recommendations did the researchers make based on the outcomes and complications of single-level and multilevel VCR surgeries?

Doctor’s Tip

A doctor might advise a patient undergoing spinal surgery to discuss with their surgeon the possibility of a single-level VCR surgery as it may have similar outcomes to multilevel surgery but with potentially less risk of complications. It’s important to weigh the benefits and risks of each type of surgery and choose the best option for the individual patient’s specific circumstances.

Suitable For

Patients who are typically recommended for spinal surgery include those with severe spinal deformities, such as scoliosis or kyphosis, that are causing pain, difficulty breathing, or other health issues. Additionally, patients with spinal tumors, spinal stenosis, herniated discs, or spinal fractures may also be recommended for surgery. The decision to undergo spinal surgery is usually made after conservative treatments, such as physical therapy or medication, have been unsuccessful in improving the patient’s symptoms.

Timeline

Before spinal surgery, a patient will typically undergo a series of diagnostic tests, consultations with their surgeon, and pre-operative preparations. This may include physical exams, imaging tests (such as X-rays or MRIs), blood tests, and possibly a consultation with an anesthesiologist.

During the surgery, the patient will be under general anesthesia and the surgeon will make an incision in the back to access the spine. The specific procedure performed will depend on the patient’s condition, but may involve removing bone or tissue, fusing vertebrae together, or placing hardware such as rods or screws to stabilize the spine.

After the surgery, the patient will typically spend some time in the hospital for monitoring and pain management. Physical therapy may be started soon after surgery to help the patient regain strength and mobility. The patient will also have follow-up appointments with their surgeon to monitor their progress and address any concerns.

Overall, the timeline of a patient’s experience before and after spinal surgery can vary depending on the specific procedure and individual factors, but typically involves several weeks to months of recovery and rehabilitation.

What to Ask Your Doctor

Some questions a patient should ask their doctor about spinal surgery include:

  1. What are the potential benefits of single-level VCR surgery compared to multilevel VCR surgery?
  2. What are the potential risks and complications associated with each type of surgery?
  3. How will the decision between single-level and multilevel VCR surgery be made for my specific case?
  4. What is the expected recovery time and rehabilitation process for each type of surgery?
  5. How will the surgery impact my daily activities and quality of life in the long term?
  6. What are the success rates of each type of surgery in correcting spinal deformities?
  7. Can you provide information on your experience and success rates with these types of surgeries?
  8. Are there any alternative treatment options to consider before proceeding with surgery?
  9. What follow-up care will be needed after the surgery, and how will my progress be monitored?
  10. Are there any specific precautions or lifestyle changes I should be aware of after the surgery?

Reference

Authors: Hwang CJ, Lenke LG, Sides BA, Blanke KM, Kelly MP. Journal: Spine (Phila Pa 1976). 2019 Jun 1;44(11):E664-E670. doi: 10.1097/BRS.0000000000002948. PMID: 30475336