Our Summary

This research paper is a comparison study that looked at the outcomes of surgeries for children with a specific type of spinal curvature called non-idiopathic scoliosis, before and after the implementation of a new care plan called the Multi-D screening protocol.

The study found that children undergoing surgery for this type of scoliosis generally experienced more complications than children with a different type of scoliosis called idiopathic scoliosis. These complications can sometimes be quite serious, even leading to death. The Multi-D screening protocol is a system that involves a team of different specialists working together to manage the child’s care, and has been shown to reduce complications in adults undergoing spine surgery.

The researchers looked at cases from a 4-year period at their hospital, comparing outcomes 2 years before and 2 years after the implementation of the Multi-D screening protocol. They found that after the implementation, there were fewer deaths within 30 days and 1 year after surgery, and fewer post-surgery neurological issues. However, the rate of surgical site infections and other secondary measures such as instrument failure, readmissions, and returns to the operating room did not change.

Overall, the study concludes that using a team-based approach like the Multi-D screening protocol can significantly reduce the risk of serious complications, including death, for children undergoing non-idiopathic scoliosis surgery.

FAQs

  1. What is the Multi-D screening protocol?
  2. How did the implementation of the Multi-D screening protocol affect the outcomes of pediatric non-idiopathic scoliosis surgeries?
  3. Did the Multi-D screening protocol reduce all types of post-surgery complications in children with non-idiopathic scoliosis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric scoliosis surgery is to make sure to follow all pre-operative and post-operative instructions carefully. This includes maintaining a healthy diet, getting regular exercise, and attending all follow-up appointments. Additionally, it is important to communicate openly with your healthcare team about any concerns or questions you may have before and after the surgery. By following these guidelines, you can help ensure a successful outcome and minimize the risk of complications.

Suitable For

Typically, pediatric scoliosis surgery is recommended for children with severe spinal curvature that is causing pain, difficulty breathing, or impacting their quality of life. In the case of non-idiopathic scoliosis, which is often associated with underlying medical conditions such as neuromuscular disorders or congenital abnormalities, surgery may be recommended if the curvature is progressing rapidly or causing significant health issues.

It is important for patients and their families to consult with a team of specialists, including pediatric orthopedic surgeons, neurosurgeons, and other healthcare providers, to determine the best course of treatment for pediatric scoliosis. The implementation of a multidisciplinary care plan, like the Multi-D screening protocol, can help ensure that these children receive the best possible care and reduce the risk of complications associated with surgery.

Timeline

Timeline before surgery:

  • Initial diagnosis of scoliosis through physical examination and imaging tests
  • Consultation with a pediatric orthopedic surgeon to discuss treatment options
  • Pre-operative evaluations including blood tests, imaging tests, and physical exams
  • Education on the surgical procedure, risks, and recovery process
  • Pre-operative physical therapy to help strengthen muscles and improve range of motion

Timeline after surgery:

  • Hospitalization for a few days to a week depending on the extent of the surgery
  • Pain management and physical therapy to help with recovery and mobility
  • Monitoring for any post-operative complications such as infections or neurological issues
  • Follow-up appointments with the surgical team for wound care and monitoring of spinal alignment
  • Gradual return to normal activities and physical therapy to continue strengthening and improving mobility
  • Long-term follow-up appointments to monitor spinal growth and alignment, as well as any potential complications or need for further treatment.

What to Ask Your Doctor

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

  1. What type of scoliosis do I have and what are the specific risks and complications associated with surgery for this type?
  2. What are the potential benefits of undergoing surgery for my scoliosis?
  3. What is the success rate of this type of surgery in children?
  4. What is the expected recovery time and rehabilitation process after surgery?
  5. What alternative treatment options are available and why is surgery recommended in my case?
  6. What is the experience of the surgical team in performing scoliosis surgery on children?
  7. How will my care be managed before, during, and after surgery? Will there be a team of specialists involved in my treatment?
  8. What is the rate of complications and mortality associated with this surgery, and how does it compare to other types of scoliosis surgery?
  9. What measures will be taken to prevent surgical site infections and other post-surgery complications?
  10. What follow-up care and monitoring will be required after surgery to ensure the best outcomes?

Reference

Authors: Deveza L, Heydemann J, Jain M, Liu D, Chhabra B, Spoede E, Kocab K, Phillips W, Hanson D, Gerow F, Wesson D, Dahl B; Texas Children’s Hospital. Journal: Spine Deform. 2021 Jan;9(1):119-124. doi: 10.1007/s43390-020-00202-5. Epub 2020 Sep 18. PMID: 32946067