Our Summary

This research paper discusses the risks involved with surgery to correct spinal deformities, and how these risks can be minimized. The dangers include damage to the spinal cord and roots, which can lead to paralysis or motor deficits after surgery. The paper talks about the use of monitoring techniques during surgery to catch any potential injuries in time to correct them before they become permanent. These techniques include somatosensory evoked potentials, which measure the nerve signals in the spinal cord, and motor evoked potentials, which measure nerve signals along the routes that control movement. Electromyography, another technique, is used to watch for unexpected signals that can indicate injury. The paper shows that these techniques are useful and can help reduce negative outcomes from the surgery. The conditions for which these techniques are used, such as scoliosis, kyphosis, and cervical myelopathy, are also discussed.

FAQs

  1. What are the potential risks involved with surgery to correct spinal deformities?
  2. What are some monitoring techniques used during surgery to prevent damage to the spinal cord and roots?
  3. How can these monitoring techniques help reduce negative outcomes from scoliosis surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scoliosis surgery is to follow all pre-operative instructions carefully to ensure the best possible outcome. This may include maintaining a healthy diet, avoiding smoking, and participating in any recommended physical therapy exercises to strengthen the muscles surrounding the spine. Additionally, it is important to have realistic expectations about the surgery and the recovery process, as it can take time to fully heal and regain strength. Finally, it is important to communicate openly with your healthcare team about any concerns or questions you may have before and after the surgery to ensure you are receiving the best care possible.

Suitable For

Patients who are typically recommended scoliosis surgery are those with severe curvature of the spine that is causing significant pain, difficulty breathing, or other complications. The decision to undergo surgery is usually made after other treatment options, such as bracing or physical therapy, have been tried and are not successful in improving the condition. Additionally, patients who are still growing and have a curvature that is progressing rapidly may also be recommended for surgery to prevent further deformity.

In addition to scoliosis, patients with kyphosis, a forward rounding of the spine, may also be recommended for surgery if the curvature is severe and causing symptoms such as back pain, breathing difficulties, or neurological issues. Cervical myelopathy, a condition in which the spinal cord in the neck is compressed, may also require surgery to relieve pressure on the spinal cord and prevent further damage.

Overall, patients who are recommended for scoliosis surgery are those who have a significant spinal deformity that is causing symptoms and affecting their quality of life. It is important for these patients to discuss the risks and benefits of surgery with their healthcare provider to determine the best course of treatment for their individual situation.

Timeline

Before scoliosis surgery, a patient will typically undergo a series of tests and evaluations to determine the severity of their spinal deformity and whether surgery is necessary. This may include X-rays, MRI scans, and physical exams. The patient will also meet with their surgeon to discuss the procedure, potential risks, and expected outcomes.

During scoliosis surgery, the patient will be under general anesthesia and the surgeon will make incisions along the spine to access and correct the spinal deformity. This may involve inserting rods, screws, or other devices to straighten and stabilize the spine. The surgery can take several hours to complete.

After scoliosis surgery, the patient will typically spend a few days in the hospital for monitoring and pain management. Physical therapy may also be recommended to help the patient regain strength and mobility in their spine. The patient will need to follow a strict recovery plan, which may include restrictions on physical activity and regular follow-up appointments with their surgeon.

Over time, the patient should experience improvements in their spinal alignment and overall quality of life. However, it is important for patients to continue to follow up with their healthcare providers to monitor their progress and address any potential complications that may arise.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery?
  2. How long is the recovery period after scoliosis surgery?
  3. What kind of physical therapy or rehabilitation will be needed after surgery?
  4. How successful is scoliosis surgery in correcting spinal deformities?
  5. What is the expected outcome in terms of pain relief and improvement in mobility after surgery?
  6. Are there any alternative treatments or less invasive procedures that could be considered instead of surgery?
  7. How experienced is the surgeon in performing scoliosis surgery?
  8. What is the long-term prognosis for someone who undergoes scoliosis surgery?
  9. What kind of follow-up care will be needed after surgery?
  10. Are there any lifestyle changes or restrictions that will need to be followed after surgery to ensure successful recovery?

Reference

Authors: Nuwer MR, MacDonald DB, Gertsch J. Journal: Handb Clin Neurol. 2022;186:179-204. doi: 10.1016/B978-0-12-819826-1.00014-4. PMID: 35772886