Our Summary

This study looked at whether a team-based approach to managing elderly patients who needed spine surgery could reduce the need for intensive care unit (ICU) resources. Researchers introduced a new way of managing these patients, where an elderly care specialist (geriatrician) was involved in the patient’s care before, during, and after surgery, alongside the usual surgical team. They compared the first 100 cases using this new method with the 25 cases that happened just before the new method was introduced. They found that the new team approach significantly reduced the need for ICU care. In fact, patients cared for under the old system were over 8 times more likely to need ICU care. The study concludes that having a team-based approach involving a geriatrician can reduce the need for ICU resources among elderly patients undergoing complex spine surgery.

FAQs

  1. What was the new method introduced for managing elderly patients who needed spine surgery?
  2. How did the team-based approach impact the need for ICU resources in elderly patients undergoing spine surgery?
  3. How much more likely were patients under the old system to need ICU care compared to those under the new team-based approach?

Doctor’s Tip

A doctor might tell a patient undergoing scoliosis surgery to follow post-operative care instructions carefully, including physical therapy and avoiding heavy lifting or strenuous activities. It is important to keep up with follow-up appointments and communicate any concerns or changes in symptoms to the medical team. Additionally, maintaining a healthy lifestyle with regular exercise and a balanced diet can help support the healing process and overall spine health.

Suitable For

Patients who are typically recommended scoliosis surgery are those who have a severe curvature of the spine that is causing pain, difficulty breathing, or impacting their quality of life. Surgery may also be recommended for patients who have a rapidly progressing curvature or for younger patients who have a curvature that is likely to worsen with growth. Additionally, patients who have tried other non-surgical treatments such as bracing or physical therapy without success may also be recommended for surgery.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis and undergoes various imaging tests to assess the severity of the curvature
  • Patient may undergo conservative treatments such as physical therapy or bracing to manage symptoms
  • Surgical consultation is scheduled to discuss the option of spinal fusion surgery

After scoliosis surgery:

  • Patient undergoes pre-operative testing and clearance for surgery
  • Surgery is performed, typically involving the insertion of metal rods and screws to straighten the spine
  • Patient is monitored closely in the recovery room and may be transferred to the ICU for observation
  • Patient begins physical therapy to regain strength and mobility
  • Follow-up appointments are scheduled to monitor progress and address any complications
  • Patient gradually resumes normal activities, with the goal of improved posture and reduced pain.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery?
  2. What is the success rate of scoliosis surgery in terms of improving spinal curvature and reducing pain?
  3. What is the recovery process like after scoliosis surgery and how long is the expected recovery time?
  4. Will physical therapy be necessary after surgery and if so, for how long?
  5. How will scoliosis surgery impact my daily activities and quality of life?
  6. Are there any alternative treatment options to consider before undergoing surgery?
  7. What is the experience of the surgical team in performing scoliosis surgeries?
  8. How often will follow-up appointments be needed after surgery?
  9. What can be done to minimize the risk of complications during and after surgery?
  10. How will my overall health and age impact the success of scoliosis surgery?

Reference

Authors: Adogwa O, Elsamadicy AA, Sergesketter AR, Ongele M, Vuong V, Khalid S, Moreno J, Cheng J, Karikari IO, Bagley CA. Journal: World Neurosurg. 2018 Mar;111:e845-e849. doi: 10.1016/j.wneu.2017.12.180. Epub 2018 Jan 6. PMID: 29317368