Our Summary

This study looked at the rates and reasons for follow-up surgeries in children who had previously undergone surgery for early onset scoliosis. The children were split into two groups based on whether they were followed up before or after 2 years from their last surgery.

There were 834 children who were followed up at least 2 years after their last operation. Of all the children, 13% needed another surgery after their last one. The most common reason for having a surgery within 2 years of the last one was infection, and the most common reason for having a surgery more than 2 years after the last one was issues with the implants that were used in the previous surgery.

The study also found that the type of final operation the children had affected the chances of needing another surgery. Children who had a spinal fusion (where two or more vertebrae are joined together) as their final operation were more likely to need another surgery than those who had their growth-friendly implants left in place or removed.

Specifically, children who underwent a revision surgery at any time, as well as those who had a surgery within 2 years of their last one, were more likely to have had a spinal fusion as their final operation. Also, children who had a surgery within 2 years of their last one, on average, needed more follow-up surgeries than children who had a surgery more than 2 years after their last one.

FAQs

  1. What were the most common reasons for follow-up surgeries in children who previously underwent scoliosis surgery?
  2. Did the type of final operation in the original scoliosis surgery affect the likelihood of needing additional surgeries?
  3. Were there differences in the frequency of follow-up surgeries between children who had a surgery within 2 years of their last one and those who had a surgery more than 2 years after their last one?

Doctor’s Tip

A helpful tip a doctor might tell a patient about scoliosis surgery is to follow all post-operative instructions carefully to reduce the risk of complications and the need for additional surgeries. It is important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare provider. Additionally, maintaining a healthy lifestyle, including regular exercise and proper nutrition, can help support the healing process and reduce the risk of future complications.

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 other health issues. In particular, patients with early onset scoliosis may require surgery if other treatments such as bracing or physical therapy are not effective in controlling the progression of the curve. Additionally, patients with progressive scoliosis that is worsening over time may also be recommended for surgery to prevent further complications.

Timeline

Before scoliosis surgery, a patient typically undergoes a series of diagnostic tests, consultations with specialists, and preoperative preparations. This may include physical exams, imaging scans, and discussions about the surgery and potential risks.

During the surgery, the patient will be under general anesthesia and the surgeon will correct the curvature of the spine using various techniques such as spinal fusion, instrumentation, or vertebral body tethering.

After the surgery, the patient will be monitored closely in the hospital for a few days to ensure proper healing and to manage pain. Physical therapy and rehabilitation may be recommended to improve mobility and strength in the spine.

In the weeks and months following the surgery, the patient will have follow-up appointments with their surgeon to monitor progress, address any complications, and adjust treatment as needed. It may take several months to fully recover from scoliosis surgery, and physical activity may be limited during this time.

Long-term follow-up care is important to monitor the spine’s alignment, growth, and any potential complications that may arise. Some patients may require additional surgeries in the future due to issues such as infection, implant failure, or progression of the curvature. Regular check-ups and imaging tests are typically recommended to ensure the best possible outcomes for patients who have undergone scoliosis surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery?

  2. How long is the recovery process expected to be and what can I do to help facilitate a successful recovery?

  3. Will I need physical therapy or rehabilitation after the surgery?

  4. How will the surgery affect my ability to participate in physical activities or sports in the future?

  5. What type of follow-up care will be required after the surgery?

  6. Are there any restrictions or lifestyle changes I will need to make following the surgery?

  7. What is the success rate of this type of surgery for patients with scoliosis?

  8. How will the surgery impact my daily life, including school or work responsibilities?

  9. Are there any alternative treatments or therapies that could be considered before opting for surgery?

  10. How often will I need to have follow-up appointments to monitor my progress and address any potential issues that may arise?

Reference

Authors: Prior A, Hardesty CK, Emans JB, Thompson GH, Sponseller PD, Smith JT, Skaggs DL, Vaughan M, Barfield WR, Murphy RF; Pediatric Spine Study Group. Journal: J Pediatr Orthop. 2023 Sep 1;43(8):481-485. doi: 10.1097/BPO.0000000000002467. Epub 2023 Jul 3. PMID: 37400093