Our Summary

This study compared two surgical techniques for treating Adolescent idiopathic scoliosis (AIS), a common type of spine curvature condition in teenagers. These techniques are posterior spinal instrumentation (PI) and vertebral body tethering (VBT) using a mini-thoracotomy approach, an incision in the chest area. The research tracked post-surgery pain, amount of morphine needed, length of hospital and intensive care stays, operation duration, patient satisfaction, and complications like bleeding and respiratory distress.

The results showed that the VBT group had significantly more pain and required more morphine after surgery. They also stayed longer in the hospital and intensive care unit. On the other hand, the PI group experienced significantly more bleeding. However, patient satisfaction and disability index scores were similar for both groups.

The study concludes that both techniques can be used to treat AIS, but extra care is needed to manage post-surgery pain for those undergoing the VBT technique. The study had a small sample size due to the rarity of AIS surgeries and was limited to a single center.

FAQs

  1. What two surgical techniques were compared in the study for treating Adolescent idiopathic scoliosis (AIS)?
  2. Which surgical technique resulted in more post-surgery pain and required a longer hospital stay?
  3. Were there any significant differences in patient satisfaction between the two surgical techniques?

Doctor’s Tip

A doctor might advise a patient undergoing scoliosis surgery to follow post-operative pain management protocols carefully, especially if they are undergoing vertebral body tethering (VBT). It is important to communicate any pain levels to your healthcare team so they can adjust your pain medication as needed. Additionally, be prepared for a potentially longer hospital stay and recovery period, especially if you are undergoing VBT. It is important to follow all post-operative instructions and attend all follow-up appointments to ensure a successful recovery.

Suitable For

Typically, scoliosis surgery is recommended for patients who have moderate to severe spinal curvature that is causing pain, discomfort, or affecting their quality of life. Patients who have not responded well to non-surgical treatments such as bracing or physical therapy may also be candidates for surgery. Additionally, surgery may be recommended for patients whose curvature is progressing rapidly and is at risk of causing further complications. Ultimately, the decision to undergo scoliosis surgery is made on a case-by-case basis by a team of healthcare professionals, including orthopedic surgeons, physical therapists, and other specialists.

Timeline

Before scoliosis surgery, a patient typically undergoes a series of diagnostic tests, consultations with specialists, and pre-operative preparations. This may include physical exams, imaging tests, blood work, and discussions about the surgical procedure, risks, and recovery process.

After scoliosis surgery, patients usually experience pain and discomfort, which is managed with pain medications. They may also require physical therapy to regain strength and mobility in the spine. Patients are closely monitored for complications such as infection, bleeding, or respiratory issues. Follow-up appointments with the surgeon are scheduled to assess the healing process and monitor the progression of the spine curvature. Over time, patients gradually resume their daily activities and may need ongoing support and follow-up care to ensure long-term success of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery, specifically with the posterior spinal instrumentation (PI) and vertebral body tethering (VBT) techniques?

  2. How long is the recovery process after scoliosis surgery, and what can I expect in terms of pain management, physical therapy, and limitations on activities?

  3. What are the success rates of the PI and VBT techniques for treating Adolescent idiopathic scoliosis (AIS), and how do they compare in terms of long-term outcomes and patient satisfaction?

  4. Will I need to undergo any additional surgeries or treatments in the future following scoliosis surgery, and what is the likelihood of complications or revision surgeries?

  5. What is the experience and expertise of the surgical team in performing scoliosis surgeries, and how many procedures have they performed using the PI and VBT techniques?

  6. Are there any alternative treatment options for scoliosis that I should consider before deciding on surgery, and what are the potential benefits and drawbacks of each option?

  7. How will scoliosis surgery affect my daily life, including activities, mobility, and overall quality of life, and what support resources are available for me during the recovery process?

  8. What is the expected timeline for scheduling and preparing for scoliosis surgery, including pre-operative appointments, tests, and consultations with other healthcare providers?

  9. Will I need to wear a brace or use any assistive devices after scoliosis surgery, and what are the recommendations for maintaining spinal health and preventing further curvature in the future?

  10. How will scoliosis surgery impact my long-term prognosis and overall health, and what follow-up care and monitoring will be necessary to ensure the best possible outcomes?

Reference

Authors: Canbolat N, Basaran I, Altun D, Akgul T, Buget MI. Journal: Pain Physician. 2022 Jul;25(4):E589-E596. PMID: 35793183