Our Summary

This research paper discusses adolescent idiopathic scoliosis (AIS) - the most common type of scoliosis mostly seen in teenagers. Treatment options depend on how much the spine has curved, the bone maturity, and the patient’s age. If the spine’s curve reaches 50 degrees, a surgical procedure known as posterior spinal fusion (PSF) becomes necessary. This procedure stabilizes the spine and stops the curvature from getting worse, but it can significantly harm the tissues and often results in substantial post-surgery pain. This article reviews ways to manage pain before, during, and after the surgery using a faster process for patients with AIS undergoing PSF.

FAQs

  1. What is the most common form of scoliosis in adolescents?
  2. When is posterior spinal fusion necessary for treating adolescent idiopathic scoliosis?
  3. What is the purpose of the accelerated protocol in pain control for patients with adolescent idiopathic scoliosis undergoing posterior spinal fusion?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric scoliosis surgery is to follow the postoperative pain management plan closely. This may include taking prescribed pain medications as directed, using ice packs or heat therapy as recommended, and participating in physical therapy to help manage pain and improve mobility. It is important to communicate any concerns or changes in pain levels to your healthcare provider to ensure proper pain control throughout the recovery process.

Suitable For

Patients who are typically recommended pediatric scoliosis surgery are those with adolescent idiopathic scoliosis (AIS) who have reached a curve degree of 50 degrees or more. The decision to undergo surgery is based on factors such as the degree of curvature, skeletal maturity, and age of the patient. Surgery, specifically posterior spinal fusion (PSF), is necessary to stabilize the spine and prevent further progression of the curve in these patients.

Timeline

Before pediatric scoliosis surgery:

  • Patient is diagnosed with adolescent idiopathic scoliosis (AIS) through physical examination and imaging studies.
  • Patient undergoes preoperative evaluations including blood tests, X-rays, and possibly MRI scans.
  • Patient and family meet with the surgical team to discuss the surgery, potential risks, and postoperative expectations.
  • Patient may undergo preoperative physical therapy to improve strength and flexibility.
  • Patient may need to stop certain medications or adjust their diet in preparation for surgery.

After pediatric scoliosis surgery:

  • Patient is closely monitored in the recovery room for a few hours before being transferred to a hospital room.
  • Patient may experience pain, discomfort, and fatigue in the immediate postoperative period.
  • Patient is encouraged to begin moving and walking with the help of physical therapy as soon as possible.
  • Patient may need to wear a brace or use assistive devices to support the spine during the initial healing phase.
  • Patient will be discharged from the hospital once they are able to manage pain and perform daily activities independently.
  • Patient will have follow-up appointments with the surgical team to monitor the healing process and address any concerns or complications.
  • Patient will continue physical therapy and possibly participate in a rehabilitation program to regain strength and mobility in the spine and surrounding muscles.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric scoliosis surgery?
  2. How long is the recovery period after surgery, and what can be done to manage pain during this time?
  3. What type of physical therapy or rehabilitation will be necessary after surgery?
  4. Will there be any long-term effects or restrictions on physical activity following surgery?
  5. How successful is pediatric scoliosis surgery in correcting spinal curvature?
  6. Are there any alternative treatment options to consider before proceeding with surgery?
  7. How often will follow-up appointments be necessary after surgery?
  8. What is the expected outcome in terms of pain relief and improved spinal alignment after surgery?
  9. How experienced is the surgical team in performing pediatric scoliosis surgeries?
  10. Are there any specific precautions or guidelines that need to be followed before and after surgery to optimize the outcome?

Reference

Authors: Locke LL, Rhodes LN, Sheffer BW. Journal: Orthop Clin North Am. 2023 Oct;54(4):427-433. doi: 10.1016/j.ocl.2023.04.003. Epub 2023 Jun 26. PMID: 37718082