Our Summary

This research paper is about a study that compared two types of surgeries used to treat adult degenerative scoliosis (ADS), a condition where the spine curves abnormally in adults due to wear and tear. The two types of surgeries are a traditional “open” surgery, and a less invasive technique called the “transpsoas” technique.

The study looked at patients who had these surgeries between 2006 and 2012, and compared the costs and quality-of-life improvements associated with each technique. Quality of life was measured by asking patients about their health before and one year after surgery. The cost of each surgery was calculated using actual costs from the province of Alberta, Canada, and included the cost of the surgery itself, the initial hospital stay, and any follow-up treatments needed due to complications.

The results showed that on average, the transpsoas technique was less expensive and resulted in better quality of life improvements than the traditional open surgery. However, if there were no complications, the open surgery was actually less expensive. The researchers also discovered that adjusting the dosage of a certain protein used in the surgery could make the transpsoas technique even more cost-effective.

The paper concludes that the transpsoas technique could be a better option for ADS patients, but more research is needed to confirm these findings.

FAQs

  1. What are the two types of surgeries compared in the study for treating adult degenerative scoliosis?
  2. How were the costs and quality-of-life improvements measured for each surgical technique?
  3. What did the research paper conclude about the transpsoas technique compared to the traditional open surgery?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about scoliosis surgery is to carefully weigh the costs and benefits of different surgical techniques. It is important to discuss with your healthcare provider about the potential outcomes, risks, and costs associated with each type of surgery before making a decision. Additionally, it is crucial to follow post-operative care instructions and attend all follow-up appointments to ensure a successful recovery.

Suitable For

Overall, patients with adult degenerative scoliosis who are recommended for surgery are those who have severe curvature of the spine that is causing pain, difficulty with daily activities, and potentially affecting their quality of life. These patients may have tried conservative treatments such as physical therapy or bracing, but have not found relief from their symptoms.

In particular, the patients in this study had adult degenerative scoliosis, which is a specific type of scoliosis that occurs in adults due to the degeneration of the spine over time. These patients may have had previous back surgeries or other spinal conditions that contributed to the development of scoliosis.

It is important for patients to discuss their treatment options with their healthcare provider and consider factors such as their overall health, age, and the severity of their condition before deciding on surgery. In some cases, surgery may be the best option to correct the curvature of the spine and alleviate pain and other symptoms associated with scoliosis.

Timeline

Before surgery, a patient with scoliosis may experience back pain, stiffness, and difficulty breathing due to the curvature of the spine. They may have tried other conservative treatments such as physical therapy, bracing, or pain medication without success.

After deciding to undergo surgery, the patient will have consultations with their surgeon to discuss the procedure, potential risks, and expected outcomes. Pre-operative testing, such as blood work, imaging studies, and cardiac evaluation, may be done to ensure the patient is a good candidate for surgery.

On the day of surgery, the patient will be admitted to the hospital and prepared for the procedure. The surgery itself can take several hours, depending on the complexity of the case. After surgery, the patient will be monitored in the recovery room before being transferred to a hospital room for further observation.

In the days following surgery, the patient will work with physical therapists to begin regaining strength and mobility. Pain medication and other supportive measures will be provided to manage discomfort and promote healing. The patient will likely need to stay in the hospital for a few days before being discharged home.

After returning home, the patient will continue with physical therapy and follow-up appointments with their surgeon to monitor their progress. It can take several weeks to months to fully recover from scoliosis surgery, and the patient may need to make adjustments to their daily activities and lifestyle during this time.

Overall, the goal of scoliosis surgery is to improve the patient’s quality of life by reducing pain, improving spinal alignment, and restoring function. With proper care and rehabilitation, most patients can expect to see significant improvements in their symptoms and overall well-being after surgery.

What to Ask Your Doctor

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

  1. What are the risks and potential complications associated with scoliosis surgery?
  2. What is the success rate of the surgery in terms of correcting the curvature of the spine?
  3. How long is the recovery period and what can I expect in terms of pain and mobility during this time?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. What type of anesthesia will be used during the surgery and what are the potential side effects?
  6. Are there any alternative treatments or less invasive procedures that could be considered?
  7. Will I need any additional surgeries or treatments in the future?
  8. How long will I need to stay in the hospital after the surgery?
  9. What are the long-term effects of scoliosis surgery and how will it impact my quality of life?
  10. Are there any specific lifestyle changes or precautions I should take after the surgery to prevent complications or further issues with my spine?

Reference

Authors: Swamy G, Lopatina E, Thomas KC, Marshall DA, Johal HS. Journal: Spine J. 2019 Feb;19(2):339-348. doi: 10.1016/j.spinee.2018.05.040. Epub 2018 May 31. PMID: 29859350