Our Summary

This study compared two types of surgery for treating adolescent idiopathic scoliosis (AIS). The first type is called minimally invasive surgery (MISS) and the second is standard posterior spinal fusion (PSF). The researchers looked at 111 patients with AIS who had either MISS or PSF between February 2019 and January 2021, and followed up with them for two years.

The MISS technique involved making two small skin incisions and only operating on the exposed part of the spine, which helped to avoid damaging muscles. The researchers looked at the degree of curve correction, the time taken for surgery, blood loss, length of hospital stay, recovery time, pain after surgery and complications.

They found that there was no significant difference between the two groups in terms of the degree of curve correction and surgery time. However, patients who had MISS had less blood loss, experienced less pain after surgery, and had a shorter hospital stay. There were also fewer complications in the MISS group.

Therefore, the study concluded that MISS is a safe and effective alternative to PSF for treating AIS in patients with curves less than 70 degrees. It offers the same degree of curve correction and surgery time, but with added benefits such as less blood loss, shorter hospital stay and less postoperative pain.

FAQs

  1. What two types of surgery were compared in this study for treating adolescent idiopathic scoliosis?
  2. What were the major findings of the study regarding minimally invasive surgery and standard posterior spinal fusion for scoliosis treatment?
  3. Is minimally invasive surgery a safe and effective alternative to standard posterior spinal fusion for all scoliosis patients?

Doctor’s Tip

One helpful tip a doctor might give a patient considering scoliosis surgery is to discuss with them the option of minimally invasive surgery (MISS) as an alternative to standard posterior spinal fusion (PSF). MISS may offer benefits such as less blood loss, shorter hospital stay, and less postoperative pain, while still providing the same degree of curve correction and surgery time. It is important to have a thorough discussion with your doctor about the different surgical options available and weigh the potential benefits and risks to make an informed decision.

Suitable For

Patients with adolescent idiopathic scoliosis (AIS) who have curves less than 70 degrees are typically recommended for scoliosis surgery. In this study, patients with AIS who had curves less than 70 degrees were found to benefit from minimally invasive surgery (MISS) compared to standard posterior spinal fusion (PSF). Patients who had MISS experienced less blood loss, less postoperative pain, and shorter hospital stays, making it a safe and effective alternative for treating AIS in this patient population.

Timeline

Before surgery:

  1. Patient is diagnosed with scoliosis through physical examination, X-rays, and possibly other imaging tests.
  2. Patient undergoes conservative treatments such as physical therapy, bracing, and monitoring of the curve progression.
  3. If conservative treatments are unsuccessful or if the curve worsens significantly, surgery may be recommended.
  4. Patient undergoes pre-operative testing and evaluation to ensure they are healthy enough for surgery.

After surgery:

  1. Patient undergoes scoliosis surgery, either minimally invasive surgery (MISS) or standard posterior spinal fusion (PSF), depending on the recommendation of their surgeon.
  2. Patient is monitored closely in the hospital for pain management, wound healing, and complications.
  3. Patient begins physical therapy to regain strength, flexibility, and mobility in the spine.
  4. Patient is discharged from the hospital and continues physical therapy and follow-up appointments with their surgeon.
  5. Over the course of the next two years, patient continues to monitor their spine for any signs of curve progression or complications from surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery, specifically MISS and PSF?
  2. How long is the recovery process for each type of surgery, and what can I expect in terms of pain management and physical therapy?
  3. What are the long-term outcomes of each surgery in terms of curve correction and overall spine health?
  4. Are there any specific factors that may make me a better candidate for one type of surgery over the other?
  5. How experienced are you in performing scoliosis surgery, and what is your success rate with both MISS and PSF procedures?
  6. Will I need any additional treatments or therapies following surgery to maintain the results and prevent further curvature of the spine?
  7. Are there any alternative treatment options to consider before deciding on surgery, and what are the potential benefits and drawbacks of each?
  8. How will scoliosis surgery affect my daily activities, such as work, exercise, and hobbies, in the long term?
  9. What is the likelihood of needing additional surgeries or treatments in the future after undergoing scoliosis surgery?
  10. Can you provide me with any patient testimonials or success stories from individuals who have undergone scoliosis surgery with similar conditions and circumstances as mine?

Reference

Authors: Vommaro F, Ciani G, Cini C, Maccaferri B, Carretta E, Boriani L, Martikos K, Scarale A, Parciante A, Leggi L, Griffoni C, Gasbarrini A. Journal: Eur Spine J. 2024 Jun;33(6):2495-2503. doi: 10.1007/s00586-024-08225-6. Epub 2024 Apr 26. PMID: 38668823