Our Summary

This research paper discusses a condition called adult spinal deformity (ASD), which is becoming more common due to an aging population. ASD is a result of wear and tear on the discs and joints in the spine, which causes the spine to become misaligned, leading to pain and disability.

The authors review recent studies on how often ASD occurs, how it’s diagnosed, and how it’s treated. They explain that treatment focuses on correcting the misalignment of the spine, particularly in the sagittal plane (a vertical plane which passes from front to rear), and relieving pressure on the nerves.

There are general goals for re-aligning the spine, including certain measurements for the sagittal vertical axis, pelvic tilt, and lumbopelvic mismatch. However, these goals may need to be adjusted depending on the patient’s specific situation.

The authors note that surgery can be quite effective for carefully selected patients and tends to yield better results than non-surgical treatments. Surgery aims to restore the alignment of the spine, relieve pressure on the nerves, and achieve fusion of the spine with minimal complications. However, the risks of surgery must be carefully considered and balanced with the potential benefits.

FAQs

  1. What is adult spinal deformity (ASD) and why is it becoming more common?
  2. What are the treatment goals and methods for ASD, particularly in terms of spinal alignment?
  3. What are the potential risks and benefits of surgery for ASD?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scoliosis surgery is to follow post-operative instructions carefully to ensure proper healing and recovery. This may include restrictions on certain activities, physical therapy exercises, and follow-up appointments with the surgeon to monitor progress. It’s important for patients to communicate any concerns or changes in symptoms to their doctor to ensure the best possible outcome.

Suitable For

Patients who are typically recommended for scoliosis surgery are those who have severe curvature of the spine that is causing pain, difficulty breathing, or other significant symptoms. Additionally, patients who have not responded well to non-surgical treatments such as bracing, physical therapy, or pain medications may be candidates for surgery.

In the case of adult spinal deformity, surgery may be recommended for patients who have significant misalignment of the spine that is causing pain, disability, or neurological symptoms. These patients may have tried other treatments without success and may have progressive deformity that is impacting their quality of life.

It is important for patients considering scoliosis surgery to consult with a spine specialist to determine if surgery is the best treatment option for their specific situation. Factors such as the severity of the curvature, the presence of symptoms, and the patient’s overall health and activity level will all be taken into consideration when making a recommendation for surgery.

Timeline

Before surgery, a patient with scoliosis will typically undergo a series of tests and evaluations to determine the severity of their condition and whether surgery is necessary. This may include physical exams, imaging tests such as X-rays and MRI scans, and possibly pulmonary function tests to assess lung function.

Once surgery is deemed necessary, the patient will meet with their surgical team to discuss the procedure, potential risks and benefits, and what to expect during the recovery process. They may also need to undergo pre-operative preparations such as blood tests and medication adjustments.

During the surgery itself, the patient will be under general anesthesia as the surgeon works to realign the spine and stabilize it with metal rods, screws, or other devices. The length and complexity of the surgery will depend on the individual patient’s condition.

After surgery, the patient will typically spend several days in the hospital for monitoring and pain management. Physical therapy will likely be started soon after surgery to help the patient regain strength and mobility. The patient will also need to follow a strict post-operative care plan, including restrictions on activities and regular follow-up appointments with their surgical team.

Over time, the patient should experience improvements in pain, posture, and overall quality of life as the spine heals and stabilizes. It may take several months to fully recover from scoliosis surgery, but with proper care and dedication to physical therapy, many patients are able to return to their normal activities with significantly improved spinal alignment.

What to Ask Your Doctor

  1. What are the specific risks and potential complications associated with scoliosis surgery?
  2. How long is the recovery time after scoliosis surgery and what can I expect during the recovery process?
  3. What type of scoliosis surgery is recommended for my specific condition and why?
  4. What are the expected outcomes of scoliosis surgery in terms of pain relief, mobility, and quality of life?
  5. Are there any alternative treatments or non-surgical options that I should consider before opting for surgery?
  6. How experienced is the surgical team in performing scoliosis surgeries and what is their success rate?
  7. Will I need physical therapy or rehabilitation after the surgery, and if so, what will that entail?
  8. Are there any long-term effects or complications that I should be aware of after undergoing scoliosis surgery?
  9. How often will I need follow-up appointments after the surgery to monitor my progress and address any concerns?
  10. Are there any lifestyle changes or restrictions that I will need to adhere to after scoliosis surgery to ensure optimal results?

Reference

Authors: Ailon T, Smith JS, Shaffrey CI, Lenke LG, Brodke D, Harrop JS, Fehlings M, Ames CP. Journal: Neurosurgery. 2015 Oct;77 Suppl 4:S75-91. doi: 10.1227/NEU.0000000000000938. PMID: 26378361