Our Summary

This research paper discusses the changes in assessing the results of spinal deformity treatment in adults. Traditionally, the focus was on the correction of the spinal curve based on radiographic analysis. Now, however, it’s more about how the patient perceives their quality of life after treatment. Two common methods used to measure patient-reported outcomes are the Oswestry Disability Index and the Scoliosis Research Society-22 Patient Questionnaire. The paper suggests that patients seem to report better outcomes when their spinal alignment is corrected. Newer methods for measuring outcomes, like looking at functional results and using accelerometers, have not yet been widely used or proven to be effective. The paper advocates for the use of a consistent set of core results to help compare and benchmark international results, which could improve value-based healthcare.

FAQs

  1. What are the predominant patient-reported outcome measurements for scoliosis surgery?
  2. How does the correction of sagittal alignment affect the patient-reported outcomes of scoliosis surgery?
  3. What is the role of functional outcomes and accelerometer measurements in assessing the results of scoliosis surgery?

Doctor’s Tip

A doctor might tell a patient considering scoliosis surgery that the surgery aims to improve both the physical alignment of the spine and the patient’s quality of life. It is important for the patient to understand that the surgery may not just focus on straightening the spine, but also on improving their overall function and well-being. It is also important for the patient to communicate their concerns and goals with their healthcare team so that the best possible outcome can be achieved.

Suitable For

Patients with moderate to severe scoliosis curvature, typically greater than 40-50 degrees, are typically recommended for scoliosis surgery. Additionally, patients who have experienced progression of their curve despite non-surgical treatments, such as bracing or physical therapy, may also be candidates for surgery. Patients who are experiencing significant pain, difficulty breathing, or other complications due to their scoliosis may also be recommended for surgery. Ultimately, the decision to undergo scoliosis surgery is made on a case-by-case basis, taking into consideration the patient’s individual circumstances and medical history.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis either through routine screening or due to symptoms such as back pain, uneven shoulders, or a visible curve in the spine.
  • Patient undergoes diagnostic tests such as X-rays, MRI, or CT scans to determine the severity and location of the spinal curvature.
  • Patient may undergo non-surgical treatments such as bracing, physical therapy, or pain management to manage symptoms and slow the progression of the curve.
  • Patient and their healthcare team discuss the risks and benefits of surgery, and decide on the best course of treatment.

After scoliosis surgery:

  • Patient undergoes the surgical procedure to correct the spinal curvature, which may involve spinal fusion, instrumentation, or other techniques.
  • Patient is monitored closely in the hospital for pain management, wound healing, and potential complications.
  • Patient begins a rehabilitation program to regain strength, mobility, and function in the spine and surrounding muscles.
  • Patient attends follow-up appointments with their surgeon to monitor the healing process, check for any complications, and adjust the treatment plan as needed.
  • Patient may experience improvements in pain, posture, mobility, and overall quality of life over time as the spine heals and stabilizes.

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 correcting the curvature of the spine?
  3. What is the expected recovery time and rehabilitation process after scoliosis surgery?
  4. Will I need to wear a brace or use any assistive devices after surgery?
  5. How will scoliosis surgery affect my daily activities and quality of life?
  6. Will I need any additional treatments or follow-up surgeries in the future?
  7. Are there any alternative treatment options to consider before opting for scoliosis surgery?
  8. How many scoliosis surgeries have you performed, and what is your success rate?
  9. Are there any long-term effects or complications that I should be aware of after scoliosis surgery?
  10. How will scoliosis surgery impact my ability to participate in sports or physical activities in the future?

Reference

Authors: Bergin SM, Abd-El-Barr MM, Gottfried ON, Goodwin CR, Shaffrey CI, Than KD. Journal: Neurosurg Clin N Am. 2023 Oct;34(4):689-696. doi: 10.1016/j.nec.2023.06.013. Epub 2023 Jul 23. PMID: 37718115