Our Summary

This study looked at the risk of delayed spinal cord injuries (SCI) in children after they have had surgery to correct spinal deformities like scoliosis or kyphosis. They examined cases from 2013-2019 in the Netherlands and found that the risk of delayed SCI might be higher than previously thought.

From the 2,884 surgeries they studied, seven kids (or about 0.24%) suffered from delayed SCI. The risk appeared to be higher in children with non-idiopathic scoliosis (a type of scoliosis that has a known cause) compared to idiopathic scoliosis (where the cause is unknown).

In all seven cases, the kids seemed fine after the surgery and were only diagnosed with SCI after a median of 16 hours post-surgery. This suggests the need for regular post-operative testing to detect and manage delayed SCI quickly and avoid serious complications.

FAQs

  1. What is the risk of delayed spinal cord injuries (SCI) in children following surgery for scoliosis or kyphosis?
  2. Are children with non-idiopathic scoliosis more likely to suffer from delayed SCI than those with idiopathic scoliosis?
  3. How long after surgery do symptoms of delayed SCI typically appear?

Doctor’s Tip

One important tip that a doctor might give to a patient about pediatric scoliosis surgery is to closely monitor for any signs of delayed spinal cord injuries (SCI) after the surgery. Regular post-operative testing and follow-up appointments are crucial in detecting and managing any potential complications early on. It is also important to discuss any concerns or changes in symptoms with your healthcare provider promptly to ensure proper treatment and care.

Suitable For

Pediatric patients who are recommended for scoliosis surgery typically have severe spinal deformities that are causing significant pain, discomfort, or functional limitations. They may have tried other non-surgical treatments such as bracing or physical therapy without success. Additionally, patients with progressive scoliosis that is getting worse over time may be recommended for surgery to prevent further curvature and potential complications. Patients with underlying conditions or syndromes that are contributing to their scoliosis may also be candidates for surgery to correct the spinal deformity and improve their quality of life.

Timeline

Before pediatric scoliosis surgery:

  • Patient undergoes pre-operative evaluations, including physical exams, imaging tests, and possibly psychological assessments
  • Patient and family meet with the surgical team to discuss the procedure, risks, and potential outcomes
  • Patient may undergo pre-operative physical therapy or other treatments to prepare for surgery

After pediatric scoliosis surgery:

  • Patient is closely monitored in the recovery room for immediate post-operative complications
  • Patient may stay in the hospital for a few days to a week for observation and pain management
  • Patient begins physical therapy and rehabilitation to regain strength and mobility
  • Patient will have follow-up appointments with the surgical team to monitor healing and address any concerns
  • Patient may need to wear a brace or undergo additional treatments to support the spine as it heals
  • Long-term follow-up care may be needed to monitor for any potential complications or issues related to the surgery

What to Ask Your Doctor

Some questions a patient should ask their doctor about pediatric scoliosis surgery in light of this study include:

  1. What steps will be taken to monitor for and detect delayed spinal cord injuries after surgery?
  2. Are there any specific risk factors that may increase the likelihood of delayed SCI in my child’s case?
  3. How frequently will my child undergo post-operative testing to check for signs of delayed SCI?
  4. What symptoms should I watch for at home that may indicate a potential issue with the spinal cord post-surgery?
  5. How will delayed SCI be managed if it is detected in my child?
  6. Are there any preventative measures or additional precautions that can be taken to reduce the risk of delayed SCI in pediatric scoliosis surgery?
  7. How common is delayed SCI in pediatric scoliosis surgery cases, and what is the typical outcome for patients who experience this complication?
  8. Are there any alternative treatment options or surgical techniques that may have a lower risk of delayed SCI in pediatric scoliosis cases?
  9. Can you provide more information about the specific cases of delayed SCI mentioned in the study and how they were managed?
  10. What is the overall success rate of pediatric scoliosis surgery in terms of long-term outcomes and potential complications, including delayed SCI?

Reference

Authors: Rutges JPHJ, Renkens JJM, Kempen DHR, Faber C, Stadhouder A, Kruyt MC, Mostert A, Horsting PP, de Klerk LWL, de Kleuver M, Castelein RM, Schlösser TPC. Journal: Spine Deform. 2023 May;11(3):617-625. doi: 10.1007/s43390-022-00626-1. Epub 2022 Dec 2. PMID: 36459389