Our Summary

This research paper discusses the importance of measuring the distance between the aorta (the main artery in the body) and the vertebrae (the bones in the spine) before performing surgery to correct scoliosis (a condition where the spine curves to the side). The relationship between the aorta and the vertebrae can change depending on the patient’s posture, the type of surgery used, and how the surgery is performed. If a screw is placed too close to the aorta during surgery, it can lead to complications. This is particularly important in patients with Marfan syndrome, a genetic disorder that can cause rapid progression of scoliosis and makes it resistant to non-surgical treatments. The aim of the paper is to highlight the importance of these measurements in improving the outcomes of scoliosis surgery.

FAQs

  1. What is the role of preoperative aorto-vertebrae metrology in scoliotic operations?
  2. What makes Marfan-related scoliosis more bracing-resistant compared to idiopathic scoliosis?
  3. How do the spatial relations between the aorta and vertebrae change with posture, surgical techniques, and operative maneuvers?

Doctor’s Tip

A doctor might tell a patient undergoing scoliosis surgery to follow post-operative care instructions carefully, including proper wound care and physical therapy exercises, to aid in recovery and prevent complications. It is also important for the patient to communicate any unusual symptoms or concerns to their healthcare provider promptly. Additionally, regular follow-up appointments and imaging studies may be necessary to monitor the spine and ensure the success of the surgery.

Suitable For

Patients who are typically recommended scoliosis surgery are those with severe curvature of the spine (usually greater than 40-50 degrees), progressive worsening of the curvature despite non-surgical treatments such as bracing, significant pain or difficulty with daily activities due to the curvature, and those who are still growing and have a high risk of the curvature worsening further. Additionally, patients with certain underlying conditions such as Marfan syndrome may also be recommended for surgery due to the specific characteristics of their scoliosis. It is important for patients to undergo careful preoperative evaluation to assess the relationship between the aorta and vertebrae to minimize the risk of complications during surgery.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis through physical examination and imaging tests.
  • Patient may undergo non-surgical treatments such as bracing or physical therapy to manage symptoms and slow progression of the curvature.
  • Patient and their medical team discuss surgical options and risks, including the potential proximity of screws to the aorta.
  • Preoperative metrology of aorto-vertebrae relations is conducted to assess the risk of aortic complications during surgery.

After scoliosis surgery:

  • Patient undergoes the surgical procedure to correct the spinal curvature, which may involve the placement of screws or other hardware near the aorta.
  • Patient is closely monitored in the hospital for complications and to manage pain.
  • Patient undergoes physical therapy and rehabilitation to regain strength and mobility in the spine.
  • Long-term follow-up care is necessary to monitor spinal alignment and manage any potential complications related to the surgery, especially in cases of Marfan-related scoliosis.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery, particularly in relation to the proximity of the aorta and other adjacent tissues?

  2. How will the surgeon ensure that the screws and instrumentation used in the surgery will not pose a risk to the aorta or other nearby structures?

  3. What specific measures will be taken during the surgery to minimize the risk of aortic complications?

  4. How will the surgeon determine the appropriate placement of screws and instrumentation in relation to the aorta and vertebrae prior to the surgery?

  5. How will the surgeon take into account any preexisting conditions, such as Marfan syndrome, that may impact the surgical approach and risk of complications?

  6. What is the expected recovery process following scoliosis surgery and how will aortic complications be monitored and managed postoperatively?

  7. Are there any alternative treatment options or surgical techniques that may reduce the risk of aortic complications while still effectively correcting the scoliosis?

  8. What is the surgeon’s experience and success rate with performing scoliosis surgeries in patients with aortic considerations?

  9. Are there any specific lifestyle changes or precautions that should be taken after the surgery to minimize the risk of aortic complications in the future?

  10. What follow-up appointments or monitoring will be necessary to ensure the long-term safety and effectiveness of the surgery, particularly in relation to the aorta and adjacent structures?

Reference

Authors: Yuan SM, Wang GR. Journal: Wien Klin Wochenschr. 2016 Feb;128(3-4):131-6. doi: 10.1007/s00508-015-0850-3. Epub 2015 Sep 15. PMID: 26373749