Our Summary

This research study looks at two different surgical approaches for treating Adult Degenerative Scoliosis (ADS), a condition where the spine curves and twists due to age-related wear and tear. The two methods are long-segment complete reconstruction and short-segment limited intervention.

The researchers looked back at the medical records of 78 patients who underwent one of these surgeries between 2012 and 2019. They compared and analyzed various details such as the patients’ age, gender, number of segments fixed in the spine, how effective the surgery was, x-ray results, and whether or not the patients needed another surgery.

They found that there were no significant differences between the two groups in terms of gender, how long they were followed up after surgery, long-term surgical complications, and the rate of needing another surgery. However, they did find that patients who had the long-segment surgery were slightly younger and had more sections of their spine fixed. These patients also had better results in terms of the angle and balance of their spine.

However, the long-segment surgery group had a higher rate of complications related to the implants used in the surgery. There was no significant difference in complications related to the adjacent segments of the spine.

In conclusion, the researchers suggest that the short-segment surgery is a better option for patients who cannot tolerate the long-segment surgery. It improves symptoms and maintains effectiveness in the mid- to long-term without increasing the need for another surgery. This is considering the risk, recovery process, and costs of the long-segment surgery.

FAQs

  1. What are the two surgical approaches for treating Adult Degenerative Scoliosis (ADS) discussed in the research study?
  2. What were the main findings of the research study comparing long-segment complete reconstruction and short-segment limited intervention for treating ADS?
  3. Based on the research study, which surgical approach is recommended for patients who cannot tolerate long-segment surgery and why?

Doctor’s Tip

One helpful tip a doctor might give a patient considering scoliosis surgery is to carefully weigh the potential benefits and risks of different surgical approaches. It is important to have a thorough discussion with your medical team to understand the expected outcomes, potential complications, and long-term effects of each option. Additionally, make sure to follow your doctor’s post-operative instructions closely to optimize your recovery and overall success of the surgery.

Suitable For

Patients with Adult Degenerative Scoliosis who are recommended for surgery typically have severe curvature of the spine, significant pain and discomfort, difficulty with daily activities, and worsening symptoms despite non-surgical treatments. Factors such as age, overall health, the location and severity of the curve, and the presence of other medical conditions will also be taken into account when determining if surgery is the best course of action. In some cases, patients may also have tried other treatments such as physical therapy, bracing, or pain management before surgery is recommended.

Timeline

Before surgery, a patient with scoliosis may experience symptoms such as back pain, posture changes, uneven shoulders, and difficulty breathing. They may undergo physical therapy, bracing, and monitoring of their condition.

After surgery, the patient will go through a recovery process that includes pain management, physical therapy, and monitoring for any complications. They will gradually increase their activity level and follow up with their surgeon for x-rays and check-ups. Over time, the patient should experience improved posture, reduced pain, and better spinal alignment. It is important for the patient to continue with regular follow-ups and adhere to any post-operative instructions to ensure the best outcome.

What to Ask Your Doctor

Questions a patient should ask their doctor about scoliosis surgery based on this research study:

  1. What are the differences between long-segment complete reconstruction and short-segment limited intervention for treating Adult Degenerative Scoliosis?
  2. How do the age and number of segments fixed in the spine affect the choice between these two surgical approaches?
  3. What are the potential long-term outcomes and effectiveness of each surgical approach?
  4. What are the risks and complications associated with each type of surgery, particularly related to implants used in the procedure?
  5. Are there any specific factors that make a patient a better candidate for one type of surgery over the other?
  6. How does the recovery process differ between long-segment and short-segment surgery?
  7. What are the costs associated with each surgical approach, including potential need for additional surgeries in the future?
  8. How will the choice of surgical approach impact my symptoms and quality of life in the long term?
  9. What are the potential benefits and drawbacks of each surgical approach in terms of improving the angle and balance of the spine?
  10. Are there any alternative treatment options or considerations I should be aware of before making a decision on scoliosis surgery?

Reference

Authors: Song Z, Zhang Z, Yang X, Zhao Z, Li T, Bi N, Wang Y. Journal: Orthop Surg. 2022 Sep;14(9):2006-2015. doi: 10.1111/os.13418. Epub 2022 Jul 25. PMID: 35876210