Our Summary

This research paper studies the use of a less invasive surgical technique, called minimally invasive fusionless surgery (MIFLS), in treating spinal muscular atrophy (SMA) scoliosis in children. SMA is a genetic disorder that weakens the muscles, often causing scoliosis, or curvature of the spine. Traditional treatment often involves fusing the spine, which can limit growth.

However, this new surgical technique aims to correct the curvature without fusing the spine, hence allowing for continued trunk growth. The procedure involves placing a sliding rod construct from the top to the bottom of the spine.

The study included 59 children with SMA who underwent this surgical procedure between 2011 and 2019. The results showed that the average curve of the spine improved significantly after the surgery. The space available for lung also improved, suggesting that the surgery didn’t interfere with respiratory function.

There were some complications, including mechanical or infectious issues in some patients, and a few needed additional surgeries. However, overall, the patients were satisfied with the surgery and there was no need for a definitive spine fusion at the end of growth.

This suggests that this new surgical technique might be a better option for treating SMA scoliosis in children, as it allows for better spine and trunk growth, has fewer complications, and doesn’t affect respiratory function.

FAQs

  1. What is minimally invasive fusionless surgery (MIFLS) and how does it differ from traditional treatment for SMA scoliosis?
  2. What were the results of the study on the use of MIFLS in treating SMA scoliosis in children?
  3. Were there any complications from the MIFLS procedure?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to follow the post-operative care instructions carefully to ensure a successful recovery. This may include physical therapy, wearing a brace if necessary, and avoiding certain activities that could put strain on the spine. It’s important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support the healing process.

Suitable For

Patients with scoliosis who are recommended for surgery typically have a severe curvature of the spine that is causing pain, difficulty breathing, or interfering with daily activities. In the case of patients with spinal muscular atrophy (SMA), surgery may be recommended if the curvature is worsening and traditional treatments such as bracing or physical therapy are not effective. Additionally, patients who are still growing and have a high likelihood of progression of the curvature may also be recommended for surgery.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis, often through a physical exam and imaging tests
  • Patient may undergo non-surgical treatments such as physical therapy, bracing, or monitoring the progression of the curvature
  • If the curvature worsens or causes pain or other symptoms, surgery may be recommended

After scoliosis surgery:

  • Patient undergoes pre-operative assessments and tests to ensure they are healthy enough for surgery
  • Surgery is performed, which may involve fusing the spine or using a less invasive technique like MIFLS
  • Patient typically stays in the hospital for a few days to recover
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Follow-up appointments are scheduled to monitor the progress of the spine and ensure there are no complications
  • Patient may need to wear a brace or limit certain activities during the recovery period
  • Over time, the patient’s spine may continue to straighten and they can gradually return to normal activities and lifestyle

What to Ask Your Doctor

  1. What are the potential risks and complications associated with minimally invasive fusionless surgery for scoliosis in children with spinal muscular atrophy (SMA)?

  2. How long is the recovery process after the surgery, and what kind of post-operative care will be needed?

  3. Will the surgery completely correct the curvature of the spine, or will additional treatments be necessary in the future?

  4. How will the surgery affect the child’s growth and development, especially considering that traditional fusion surgery can limit growth?

  5. What are the long-term outcomes and success rates of this surgical technique for treating SMA scoliosis in children?

  6. Are there any alternative treatment options available for SMA scoliosis, and how does minimally invasive fusionless surgery compare to them?

  7. Will the surgery affect the child’s ability to participate in physical activities or sports in the future?

  8. How experienced is the surgical team in performing minimally invasive fusionless surgery for SMA scoliosis, and what is their success rate with this procedure?

  9. Will the surgery require any additional therapies or follow-up appointments to monitor the child’s progress and ensure the success of the procedure?

  10. What kind of lifestyle changes or adjustments will be necessary for the child after undergoing minimally invasive fusionless surgery for SMA scoliosis?

Reference

Authors: Gaume M, Saudeau E, Gomez-Garcia de la Banda M, Azzi-Salameh V, Mbieleu B, Verollet D, Benezit A, Bergounioux J, Essid A, Doehring I, Dabaj I, Desguerre I, Barnerias C, Topouchian V, Glorion C, Quijano-Roy S, Miladi L. Journal: J Pediatr Orthop. 2021 Oct 1;41(9):549-558. doi: 10.1097/BPO.0000000000001897. PMID: 34411042