Our Summary

This research paper is about defining ‘operative time’ for a specific type of spine surgery – posterior spinal fusion surgeries for adolescent idiopathic scoliosis (AIS). The time taken for surgery is important to understand the risks, assess how surgeons learn, and evaluate the efficiency of the surgical team. However, there isn’t a standard definition for ‘operative time’ in medical studies.

The researchers looked at many studies, but found that only a small number actually defined what they meant by ‘operative time’. Most of these defined it as the time from the first cut to the wound being closed. The median (or middle) time for these surgeries was about 248 minutes, but it could be as short as 174 minutes or as long as 448 minutes.

For the studies that didn’t define ‘operative time’, the median time was slightly longer at 252 minutes, but the range was much wider, from 139 to 523 minutes.

The researchers suggest that ‘operative time’ should be clearly defined in each study, from the time of the first incision to when the bandage is applied to the wound. This would help to standardize the results of different studies. The evidence level of this research is IV, which means it’s based on expert committee reports or opinions and/or clinical experience of respected authorities.

FAQs

  1. What is the importance of defining ‘operative time’ for posterior spinal fusion surgeries for adolescent idiopathic scoliosis (AIS)?
  2. What was the median ‘operative time’ found in the studies that defined it, and how does it compare to those that did not define it?
  3. What does the evidence level IV mean in the context of this research on ‘operative time’ for scoliosis surgery?

Doctor’s Tip

A doctor might tell a patient considering scoliosis surgery that the operative time can vary depending on the complexity of the surgery and individual factors. It’s important to discuss with your surgeon what to expect in terms of the length of the procedure and recovery time. Additionally, following post-operative instructions and attending follow-up appointments are crucial for a successful outcome.

Suitable For

Patients who are typically recommended scoliosis surgery are those with adolescent idiopathic scoliosis (AIS) who have a curve greater than 40-50 degrees and are still growing. Surgery is usually recommended when the curve is progressing rapidly, causing pain, affecting lung function, or impacting the patient’s quality of life. Other factors that may influence the recommendation for surgery include the patient’s age, skeletal maturity, overall health, and response to non-surgical treatments.

Timeline

Before scoliosis surgery, a patient typically undergoes a series of diagnostic tests such as X-rays, MRI scans, and physical examinations to determine the severity of the curvature of the spine. They may also undergo non-surgical treatments such as physical therapy or bracing to help manage their condition.

After deciding to proceed with surgery, the patient will meet with their surgical team to discuss the procedure, potential risks, and expected outcomes. They may also undergo pre-operative testing such as blood work and EKG to ensure they are healthy enough for surgery.

On the day of the surgery, the patient will be admitted to the hospital and prepared for the procedure. The surgery itself typically lasts between 2 to 6 hours, depending on the complexity of the case. During the surgery, the surgeon will use metal rods, screws, and bone grafts to correct the curvature of the spine.

After the surgery, the patient will be closely monitored in the hospital for a few days to ensure they are healing properly and managing their pain. They will gradually start physical therapy to help strengthen their back muscles and improve their range of motion. The recovery process can take several weeks to months, and the patient may need to wear a back brace for support during this time.

Overall, scoliosis surgery is a significant procedure that requires careful planning and post-operative care to ensure the best possible outcome for the patient.

What to Ask Your Doctor

Some questions a patient should ask their doctor about scoliosis surgery include:

  1. What is the expected length of the surgery for my specific case of scoliosis?
  2. What factors can affect the length of the surgery?
  3. What are the potential risks and complications associated with scoliosis surgery?
  4. How experienced is the surgical team in performing scoliosis surgeries?
  5. What is the expected recovery time after the surgery?
  6. Will physical therapy be necessary after the surgery?
  7. What are the long-term outcomes of scoliosis surgery?
  8. Are there any alternative treatment options to consider before proceeding with surgery?
  9. How can I best prepare for surgery, both physically and mentally?
  10. Are there any restrictions or limitations I should be aware of after the surgery?

Reference

Authors: Wagala NN, Marasigan JAM, Mian HM, Schwend RM. Journal: J Pediatr Orthop B. 2021 May 1;30(3):205-210. doi: 10.1097/BPB.0000000000000754. PMID: 32558776