Our Summary

This research paper compares the effectiveness of two different types of surgery: minimally invasive surgery (MIS) and open surgery, for the treatment of adult degenerative scoliosis (ADS). ADS is a condition that affects adults, causing the spine to curve due to wear and tear on the discs and joints in the spine. This can lead to severe back pain and other symptoms that often need surgical treatment.

The scientists looked at 11 different studies, which included 1527 patients in total. They found that open surgery took less time to perform, and resulted in better improvements in the curve of the lower spine and the tilt of the pelvis. However, patients who had minimally invasive surgery lost less blood during the operation, stayed in the hospital for less time, and had fewer serious complications after the surgery.

When it came to improvements in the overall curve of the spine, pain relief, and improvement in the sagittal vertical axis (a measure of balance), both types of surgery were equally effective.

In simpler terms, while open surgery works a bit better for some aspects (like improving the curve of the lower spine and pelvic tilt), minimally invasive surgery is less risky and requires a shorter hospital stay. Both types were equally effective in terms of overall improvements to the spine’s curve, pain relief, and balance.

FAQs

  1. What is the difference between minimally invasive surgery and open surgery for the treatment of adult degenerative scoliosis?
  2. Which type of surgery for adult degenerative scoliosis results in less blood loss and a shorter hospital stay?
  3. Are both minimally invasive and open surgeries equally effective in terms of overall improvements to the spine’s curve, pain relief, and balance?

Doctor’s Tip

A doctor might tell a patient considering scoliosis surgery that both minimally invasive and open surgery are effective options, but that minimally invasive surgery may have fewer risks and a shorter recovery time. It’s important to discuss the pros and cons of each type of surgery with your doctor to determine the best option for your specific situation.

Suitable For

Overall, patients with adult degenerative scoliosis who are recommended for surgery are typically those who have severe back pain and other symptoms that significantly impact their quality of life. These patients may have tried non-surgical treatments like physical therapy or medication without success. Additionally, patients with significant spinal curvature or deformity may also be candidates for surgery to correct the curve and prevent further progression of the condition.

Ultimately, the decision to undergo surgery for scoliosis is made on a case-by-case basis, taking into account the patient’s overall health, the severity of their symptoms, and the potential risks and benefits of surgery. It is important for patients to discuss their options with a spine specialist to determine the most appropriate treatment plan for their individual needs.

Timeline

Before surgery:

  1. Patient is diagnosed with adult degenerative scoliosis and discusses treatment options with their doctor.
  2. Patient undergoes pre-operative testing and evaluation to determine if they are a candidate for surgery.
  3. Patient may undergo physical therapy or other conservative treatments to manage symptoms before surgery.
  4. Patient meets with their surgeon to discuss the surgical procedure, risks, and recovery process.

After surgery:

  1. Patient undergoes either open or minimally invasive surgery to correct the spinal curvature.
  2. Patient is monitored closely in the hospital for a few days to manage pain and monitor for any complications.
  3. Patient may require physical therapy or rehabilitation to regain strength and mobility in the spine.
  4. Patient follows a post-operative care plan, which may include restrictions on activity and follow-up appointments with their surgeon.
  5. Over time, patient experiences improvements in pain, spinal alignment, and overall function as they continue to recover from surgery.

What to Ask Your Doctor

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

  1. What type of surgery (minimally invasive or open) do you recommend for my specific case of adult degenerative scoliosis?
  2. What are the potential risks and complications associated with each type of surgery?
  3. How long will the surgery take to perform?
  4. How long is the typical hospital stay for each type of surgery?
  5. What is the expected recovery time and rehabilitation process for each type of surgery?
  6. Will I need any additional treatments or therapies after the surgery?
  7. What are the expected outcomes in terms of pain relief, improvement in spine curvature, and overall quality of life for each type of surgery?
  8. Are there any specific factors about my health or condition that may influence the choice of surgery type?
  9. Can you provide me with information about your experience and success rates with each type of surgery?
  10. Are there any alternative treatment options to consider before proceeding with surgery?

Reference

Authors: Shao Z, Liang H, Li S, Ye Z, Wang X. Journal: Spine (Phila Pa 1976). 2024 Jul 15;49(14):E210-E220. doi: 10.1097/BRS.0000000000005011. Epub 2024 Apr 10. PMID: 38597179