Our Summary

This research paper is about a study conducted by the Japanese Scoliosis Society Morbidity & Mortality Committee. They looked at complications following surgery for spinal deformity in children from 2012 to 2017. The types of spinal deformities they looked at included idiopathic scoliosis (where the cause isn’t known), congenital scoliosis (present at birth), neuromuscular scoliosis (related to muscle or nerve conditions), other types of scoliosis, and kyphosis (a forward curvature of the spine). They also looked at various complications, such as death, blindness, neurological problems, infection, heavy bleeding, blood clots, pneumonia, heart failure, stomach perforation, and issues with the surgical hardware.

The study showed that overall, the rate of complications after surgery has gone down from 10.7% in 2012 to 8.1% in 2017. The rate of complications in patients with idiopathic scoliosis particularly decreased from 8.8% in 2012 to 4.0% in 2017. However, the complication rates for patients with neuromuscular scoliosis and kyphosis remained high. They found that neurological problems, specifically those related to movement, decreased significantly from 2.0% in 2012 to 0.7% in 2017, with the highest rates in patients with kyphosis. Heavy bleeding also decreased significantly, especially in patients with neuromuscular scoliosis. However, these patients had a high rate of pneumonia after surgery. The rate of problems with the surgical hardware was also high, especially in patients with early onset idiopathic, congenital, and other types of scoliosis.

In conclusion, while the overall complication rates have decreased, especially in patients with idiopathic scoliosis, the rates remain high in patients with neuromuscular scoliosis and kyphosis.

FAQs

  1. What types of spinal deformities were studied in this research?
  2. How has the overall rate of complications after pediatric scoliosis surgery changed between 2012 and 2017?
  3. Which types of scoliosis patients had the highest complication rates after surgery?

Doctor’s Tip

A doctor might tell a patient considering pediatric scoliosis surgery that while the overall complication rates have decreased over the years, it is important to be aware of the specific risks associated with their type of spinal deformity. They may also advise the patient to discuss these risks thoroughly with their surgical team and to follow all post-operative instructions carefully to minimize the chances of complications. Additionally, the doctor may recommend regular follow-up appointments to monitor the patient’s progress and address any concerns promptly.

Suitable For

Therefore, pediatric scoliosis surgery is typically recommended for patients with idiopathic scoliosis, as they have lower complication rates compared to patients with other types of spinal deformities. Patients with neuromuscular scoliosis and kyphosis may still benefit from surgery, but they should be closely monitored for potential complications, such as neurological problems, pneumonia, and issues with the surgical hardware. It is important for healthcare providers to carefully consider the risks and benefits of surgery for each individual patient and to provide appropriate post-operative care to minimize complications.

Timeline

Before pediatric scoliosis surgery, a patient typically undergoes a series of diagnostic tests, consultations with specialists, and pre-operative preparations. This may include physical exams, imaging tests (X-rays, MRI, CT scans), blood tests, and possibly bracing or physical therapy. The patient and their family also meet with the surgical team to discuss the procedure, potential risks, and post-operative care.

After the surgery, the patient is closely monitored in the hospital for several days to manage pain, prevent infection, and ensure proper healing. Physical therapy may be initiated soon after surgery to help the patient regain strength and mobility. The patient will gradually transition to normal activities and follow-up appointments with the surgical team to monitor their progress and address any concerns.

Overall, the timeline of a patient’s experience before and after pediatric scoliosis surgery involves thorough preparation, the surgical procedure itself, post-operative care, and ongoing monitoring and rehabilitation to achieve the best possible outcome.

What to Ask Your Doctor

Here are some questions a patient should ask their doctor about pediatric scoliosis surgery based on this study:

  1. What is the specific type of scoliosis I have (idiopathic, congenital, neuromuscular, kyphosis, etc.) and how does that impact my risk of complications during surgery?
  2. What steps will be taken to minimize the risk of complications during and after surgery?
  3. What is the success rate of this type of surgery for my specific condition?
  4. What are the most common complications associated with this type of surgery, and how are they typically managed?
  5. What is the rate of neurological problems, heavy bleeding, pneumonia, and issues with surgical hardware for patients with my type of scoliosis?
  6. Are there any alternative treatment options to surgery that may be appropriate for my case?
  7. How long is the recovery process expected to be, and what support will be available to me during this time?
  8. What is the long-term outlook for patients who undergo this type of surgery?
  9. How often will I need to follow up with you after the surgery, and what signs should I watch for that may indicate a complication?
  10. Can you provide me with any additional resources or information to help me understand the risks and benefits of pediatric scoliosis surgery?

Reference

Authors: Sugawara R, Takeshita K, Takahashi J, Arai Y, Watanabe K, Yamato Y, Oba H, Matsumoto M. Journal: J Orthop Sci. 2021 Sep;26(5):744-749. doi: 10.1016/j.jos.2020.07.007. Epub 2020 Aug 14. PMID: 32800635