Our Summary

This research paper is a review of previous studies on the recurrence of spinal stenosis, which is a narrowing of the spaces within your spine, after initial surgery. The authors looked at two types of surgery: one where only the affected part of the spine is operated on (decompression), and another where parts of the spine are joined together (fusion). They found 31 relevant studies and divided them into three categories: studies on repeat surgery after decompression, studies on repeat surgery after decompression and fusion, and studies that diagnosed stenosis during surgery.

The authors concluded that it is important to give advice to help prevent the need for repeat surgeries. They suggest that when doing decompression surgery without fusion, doctors should carefully analyze the risk of instability caused by the surgery. They also highlighted the importance of proper pre-operative planning and the use of neuromonitoring and CT scans during surgery, especially in complex cases, to avoid persistent stenosis.

In other words, the paper is about how to reduce the risk of needing more surgery after initial treatment for spinal stenosis. The advice includes careful planning before surgery and using advanced technology during surgery.

FAQs

  1. What types of surgery were considered in the studies reviewed in this research paper?
  2. What advice do the authors give to help prevent the need for repeat surgeries after initial treatment for spinal stenosis?
  3. How can the use of advanced technology during surgery help in reducing the risk of repeat surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about scoliosis surgery is to follow all post-operative instructions and attend all follow-up appointments. This will help ensure proper healing and monitor for any potential complications. It is also important to engage in physical therapy and rehabilitation as recommended by your healthcare team to strengthen the muscles around the spine and improve overall function. Finally, maintaining a healthy lifestyle with regular exercise and proper nutrition can help support long-term spinal health.

Suitable For

Typically, patients who are recommended for scoliosis surgery are those who have a severe curvature of the spine that is causing pain, difficulty breathing, or impacting their quality of life. Other factors that may lead to a recommendation for surgery include progression of the curvature despite conservative treatment, significant deformity of the spine, or neurological symptoms such as weakness or numbness in the extremities.

Patients who have not responded well to other treatments such as bracing, physical therapy, or observation may also be recommended for surgery. Additionally, patients who are still growing and have a curvature that is likely to progress may be considered for surgery to prevent further complications in the future.

Ultimately, the decision to recommend scoliosis surgery is made on a case-by-case basis by a team of healthcare providers, including orthopedic surgeons, physical therapists, and other specialists, taking into account the individual patient’s unique circumstances and overall health.

Timeline

Before scoliosis surgery:

  • Patient is diagnosed with scoliosis through physical examination and imaging tests.
  • Patient undergoes pre-operative evaluations to assess overall health and determine the best treatment plan.
  • Patient may undergo physical therapy or other non-surgical treatments to manage symptoms and improve spine alignment.
  • Patient and surgeon discuss the risks and benefits of surgery and set expectations for the recovery process.

After scoliosis surgery:

  • Patient undergoes the surgical procedure to correct the curvature of the spine.
  • Patient may stay in the hospital for a few days for monitoring and pain management.
  • Patient begins physical therapy and rehabilitation to regain strength and flexibility in the spine.
  • Patient follows a post-operative care plan, including avoiding certain activities and gradually increasing physical activity.
  • Patient attends follow-up appointments with the surgeon to monitor progress and address any concerns.
  • Patient may experience improvements in pain, posture, and overall quality of life as the spine heals and stabilizes.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with scoliosis surgery?
  2. How long is the recovery process typically after scoliosis surgery?
  3. Will I need physical therapy or rehabilitation after surgery?
  4. What type of scoliosis surgery is recommended for my specific case?
  5. How successful is scoliosis surgery in correcting spinal curvature?
  6. Are there any alternative treatments or non-surgical options for scoliosis that I should consider?
  7. How long will I need to stay in the hospital after scoliosis surgery?
  8. What type of post-operative care and follow-up appointments will be necessary?
  9. How likely is it that I will need additional surgery in the future after scoliosis surgery?
  10. What can I do to help prevent the need for repeat surgeries in the future?

Reference

Authors: Le Huec JC, Seresti S, Bourret S, Cloche T, Monteiro J, Cirullo A, Roussouly P. Journal: Eur Spine J. 2020 Feb;29(Suppl 1):22-38. doi: 10.1007/s00586-020-06314-w. Epub 2020 Jan 29. PMID: 31997016