Our Summary

This research paper is a review and analysis of various studies to compare the safety and effectiveness of two methods of spinal fusion surgery for adults with spinal deformities: one where the surgery is done all at once (same-day), and the other where it is split into two smaller procedures (staged). Spinal deformity surgeries can have a high rate of complications, between 10% to 40%.

The researchers looked at 11 studies involving 1323 patients - 541 had staged surgeries and 782 had same-day surgeries. They found that staged surgeries took longer and resulted in longer hospital stays. They also found a higher risk of blood clots in the veins (venous thromboembolism) in staged surgeries. The most common complication for staged surgeries was infection at the surgery site, while for same-day surgeries it was neurological complications.

However, they found no significant differences between the two types of surgeries in terms of blood loss, clinical and radiological outcomes, and overall complication rates.

In simple words, both methods have their own risks and benefits, and the choice should depend on each patient’s specific condition.

FAQs

  1. What are the two methods of spinal fusion surgery for adults with spinal deformities?
  2. What are the common complications of staged and same-day spinal surgeries?
  3. Are there any significant differences between the two types of spinal surgeries in terms of blood loss, clinical and radiological outcomes, and overall complication rates?

Doctor’s Tip

A helpful tip a doctor might give to a patient considering spinal surgery is to thoroughly discuss the risks and benefits of each type of surgery with their healthcare team. It is important for the patient to ask questions, express any concerns, and make an informed decision based on their individual needs and preferences. Additionally, following pre-operative and post-operative instructions, such as maintaining a healthy lifestyle, attending physical therapy, and avoiding heavy lifting, can help improve the success and recovery of the surgery.

Suitable For

Patients who are typically recommended spinal surgery include those with severe spinal deformities such as scoliosis, kyphosis, or spondylolisthesis that are causing significant pain, mobility issues, or neurological symptoms. Other conditions that may warrant spinal surgery include spinal stenosis, herniated discs, fractures, tumors, or infections in the spine.

Patients who have not found relief from conservative treatments such as physical therapy, medication, or injections may also be candidates for spinal surgery. Additionally, patients who have progressive spinal deformities that are affecting their quality of life or causing complications such as difficulty breathing may be recommended for surgery.

Overall, the decision to undergo spinal surgery is complex and should be made in consultation with a spine specialist who can assess the individual patient’s condition, risks, and potential benefits of surgery.

Timeline

Before spinal surgery, a patient typically undergoes various diagnostic tests such as X-rays, MRI scans, and blood tests to determine the extent of the spinal deformity and assess overall health. They may also meet with a team of healthcare professionals including a surgeon, anesthesiologist, and physical therapist to discuss the procedure and post-operative care.

During the surgery, the patient is placed under general anesthesia and the surgeon makes incisions to access the spine. Depending on the type of surgery, the surgeon may use screws, rods, or bone grafts to stabilize and realign the spine. The duration of the surgery varies depending on the complexity of the deformity.

After the surgery, the patient is typically monitored in the recovery room before being transferred to a hospital room. They may experience pain, swelling, and limited mobility in the days following the surgery. Physical therapy and pain management techniques are often used to help the patient recover and regain strength.

Overall, the recovery process can be lengthy and challenging, with the patient needing to follow a strict post-operative care plan to ensure successful healing and long-term outcomes. Regular follow-up appointments with the healthcare team are necessary to monitor progress and address any complications that may arise.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with the specific type of spinal surgery being recommended?
  2. How long is the recovery process expected to be, and what limitations or restrictions will I have during this time?
  3. What is the success rate of this type of surgery for patients with my specific spinal deformity?
  4. Are there alternative treatment options available that do not involve surgery?
  5. How experienced are you in performing this type of surgery, and what is your success rate?
  6. Will I require physical therapy or rehabilitation after the surgery, and if so, for how long?
  7. What is the expected long-term outcome of the surgery, and what lifestyle changes may be necessary post-surgery?
  8. What steps can I take to minimize the risk of complications during and after the surgery?
  9. How will pain management be handled during the recovery period?
  10. Are there any specific precautions or warning signs I should be aware of after the surgery?

Reference

Authors: Verma A, Bondarde P, Kumar A, Sethy SS, Jain A, Abrol V, Ahuja K, Kandwal P. Journal: Spine (Phila Pa 1976). 2025 Jun 15;50(12):859-870. doi: 10.1097/BRS.0000000000005279. Epub 2025 Jan 30. PMID: 39882640