Our Summary

This research paper examines whether it’s safe and effective to use antifibrinolytics (drugs that help reduce bleeding) during a specific type of spine surgery for teenagers with a condition called idiopathic scoliosis (an unexplained curvature of the spine). The researchers looked at data from a large national database and compared patients who were given antifibrinolytics during surgery with those who weren’t.

They found that patients given these drugs tended to have more complex surgeries, but after taking this into account, there were no significant differences between the two groups in terms of the amount of blood transfusions needed, the rate of return to the operating room, readmission to the hospital within 30 days, complications after surgery, or the length of time spent in intensive care or the hospital.

The study didn’t show a reduction in the need for blood transfusions in the group given antifibrinolytics. This could be due to a lack of standardised protocols for using these drugs in pediatric spine surgery, or it might be because patients with more complex surgeries were more likely to be given these drugs. However, the use of antifibrinolytics appeared to be safe and wasn’t linked to an increase in complications around the time of surgery.

FAQs

  1. What is the purpose of using antifibrinolytics during spine surgery for teenagers with idiopathic scoliosis?
  2. Did the use of antifibrinolytics reduce the need for blood transfusions during scoliosis surgery according to the study?
  3. Were there any increased complications linked to the use of antifibrinolytics during pediatric spine surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric scoliosis surgery is to discuss the use of antifibrinolytics with their surgeon. While this study showed no significant difference in outcomes for patients who were given these drugs during surgery, it’s important for the patient and their family to have an open conversation with the medical team about the potential benefits and risks of using antifibrinolytics in their specific case. It’s always important for patients to be well informed and to ask questions about their treatment options.

Suitable For

Pediatric scoliosis surgery is typically recommended for patients with severe curvature of the spine that is progressive, causing pain, difficulty breathing, or impacting their quality of life. Patients who have failed non-surgical treatments such as bracing or physical therapy may also be candidates for surgery. Additionally, patients with certain underlying conditions such as neuromuscular scoliosis or congenital scoliosis may also require surgical intervention.

In the case of the study mentioned above, patients with idiopathic scoliosis undergoing surgery were the focus. Idiopathic scoliosis is the most common type of scoliosis and typically occurs in adolescents with no known cause. The study aimed to determine the safety and effectiveness of using antifibrinolytics during surgery in this specific patient population.

Overall, pediatric scoliosis surgery is recommended for patients who have significant curvature of the spine that is impacting their health and quality of life. The decision to undergo surgery is typically made after a thorough evaluation by a multidisciplinary team of specialists, including orthopedic surgeons, neurosurgeons, and pediatricians. Each patient’s individual circumstances, including the severity of the curvature, age, overall health, and potential risks and benefits of surgery, are taken into consideration when determining the best course of treatment.

Timeline

Before pediatric scoliosis surgery, a patient will typically undergo a series of diagnostic tests such as X-rays, MRIs, and physical examinations to determine the severity of the curvature of their spine. They may also undergo non-surgical treatments such as bracing or physical therapy to try to manage the condition.

After surgery, the patient will typically spend a few days in the hospital recovering. They may experience pain and discomfort, which can be managed with medication. Physical therapy will be an important part of their recovery process to help strengthen their muscles and improve their range of motion.

Over the following months, the patient will have follow-up appointments with their surgeon to monitor their progress and ensure that their spine is healing properly. They may also continue with physical therapy to help improve their strength and flexibility.

Overall, the goal of pediatric scoliosis surgery is to correct the curvature of the spine and improve the patient’s quality of life. With proper care and rehabilitation, most patients are able to return to their normal activities and enjoy a better quality of life after surgery.

What to Ask Your Doctor

  1. What is the specific surgical procedure that will be performed for my child’s scoliosis?
  2. What are the potential risks and complications associated with pediatric scoliosis surgery?
  3. Why is the use of antifibrinolytics being considered for my child’s surgery?
  4. What are the potential benefits of using antifibrinolytics during my child’s surgery?
  5. Are there any alternative treatment options to surgery for my child’s scoliosis?
  6. How experienced is the surgical team in performing pediatric scoliosis surgeries?
  7. What is the expected recovery time and rehabilitation process after surgery?
  8. Will my child need any additional treatments or therapies after surgery?
  9. How often will my child need follow-up appointments after surgery?
  10. Are there any long-term implications or considerations for my child’s health and well-being after scoliosis surgery?

Reference

Authors: Bovonratwet P, Sheha ED, Ondeck NT, Malpani R, Smith BG, Grauer JN. Journal: Clin Spine Surg. 2020 Feb;33(1):E26-E32. doi: 10.1097/BSD.0000000000000836. PMID: 31162181