Our Summary

This research paper is about Adolescent idiopathic scoliosis (AIS), the most common type of spinal deformity in teenagers. It affects between 1% and 4% of adolescents, especially during the early stages of puberty, and is more common in girls than boys. The condition happens in otherwise healthy individuals, and its cause is still unknown. Over the years, significant progress has been made in understanding AIS, its clinical patterns, and its three-dimensional structure. Technological advancements and biomechanics have led to improvements in the safety and results of both surgical and non-surgical treatments. However, the exact cause and mechanisms behind AIS are yet to be discovered. As a result, there are currently no ways to prevent AIS or treat its direct underlying cause.

FAQs

  1. What is Adolescent idiopathic scoliosis (AIS) and how common is it in teenagers?
  2. What advancements have been made in the treatment of AIS?
  3. Is there currently a way to prevent or directly treat the underlying cause of AIS?

Doctor’s Tip

A doctor may advise a patient undergoing pediatric scoliosis surgery to follow post-operative care instructions carefully, including proper wound care, physical therapy exercises, and restrictions on activities to promote healing and prevent complications. They may also recommend regular follow-up appointments to monitor progress and address any concerns or complications that may arise. It is important for the patient and their family to communicate openly with the medical team and ask any questions they may have throughout the recovery process.

Suitable For

Pediatric scoliosis surgery is typically recommended for patients with AIS who have a curve greater than 50 degrees, are still growing, and have failed to respond to non-surgical treatments such as bracing or physical therapy. Surgery may also be recommended for patients with rapidly progressing curves, significant pain or discomfort, or cosmetic concerns.

In general, surgery is considered when the curve is severe enough to affect the patient’s quality of life, cause physical limitations, or lead to potential long-term complications such as respiratory problems or spinal deformity. The decision to undergo surgery is typically made in collaboration with a multidisciplinary team of healthcare providers, including orthopedic surgeons, pediatricians, physical therapists, and psychologists, to ensure that the benefits of surgery outweigh the risks.

Overall, pediatric scoliosis surgery is a safe and effective treatment option for patients with AIS who meet the criteria for surgery. It can help improve spinal alignment, reduce pain and discomfort, and prevent further progression of the curve, allowing patients to lead more active and fulfilling lives.

Timeline

Before pediatric scoliosis surgery:

  1. Diagnosis: The patient is typically diagnosed with scoliosis during a routine physical exam or screening at school. X-rays and other imaging tests are done to confirm the diagnosis and determine the severity of the curvature.
  2. Monitoring: The patient may undergo periodic check-ups to monitor the progression of the scoliosis and to determine if surgery is necessary.
  3. Non-surgical treatments: The patient may undergo non-surgical treatments such as bracing or physical therapy to help slow down the progression of the curvature.
  4. Decision for surgery: If the curvature of the spine continues to worsen despite non-surgical treatments, the patient and their family may decide to proceed with surgery.

After pediatric scoliosis surgery:

  1. Hospital stay: The patient will typically stay in the hospital for a few days after surgery to recover and be monitored for any complications.
  2. Rehabilitation: The patient will undergo physical therapy and rehabilitation to help strengthen their muscles and improve their mobility after surgery.
  3. Follow-up appointments: The patient will have regular follow-up appointments with their surgeon to monitor their progress and ensure that the spine is healing properly.
  4. Long-term monitoring: The patient may need long-term monitoring to ensure that the curvature of the spine does not worsen again in the future.
  5. Improved quality of life: In many cases, pediatric scoliosis surgery can help improve the patient’s quality of life by reducing pain, improving posture, and preventing further progression of the curvature.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric scoliosis surgery?
  2. What is the success rate of pediatric scoliosis surgery in terms of correcting the curvature of the spine?
  3. What is the expected recovery time and rehabilitation process following pediatric scoliosis surgery?
  4. Are there any long-term effects or limitations that may result from pediatric scoliosis surgery?
  5. What alternatives to surgery are available for treating pediatric scoliosis, and what are the pros and cons of each option?
  6. How experienced is the surgical team in performing pediatric scoliosis surgery?
  7. What type of surgical approach or technique will be used for the specific case of pediatric scoliosis?
  8. What is the expected outcome in terms of pain relief and improved quality of life following pediatric scoliosis surgery?
  9. Will additional surgeries or treatments be necessary in the future for managing pediatric scoliosis?
  10. Are there any lifestyle changes or precautions that should be taken after pediatric scoliosis surgery to prevent complications or recurrence of the condition?

Reference

Authors: Cheng JC, Castelein RM, Chu WC, Danielsson AJ, Dobbs MB, Grivas TB, Gurnett CA, Luk KD, Moreau A, Newton PO, Stokes IA, Weinstein SL, Burwell RG. Journal: Nat Rev Dis Primers. 2015 Sep 24;1:15030. doi: 10.1038/nrdp.2015.30. PMID: 27188385