Our Summary

This research paper discusses a rare case where a 12-year-old girl experienced a stroke after having surgery for scoliosis. The stroke, which was diagnosed 12 hours after the operation, was unusual because it was not connected to a longer surgical procedure or any underlying disease. The girl was treated with anticoagulants (drugs that prevent blood clots) and made a full recovery after two months. This case is significant because strokes are typically more common in adults and are not usually seen in children after scoliosis surgery. The researchers stress the importance of being aware of this potential complication so that it can be quickly diagnosed and treated.

FAQs

  1. What happened to the 12-year-old girl who had surgery for scoliosis?
  2. Are strokes common in children after scoliosis surgery?
  3. How was the stroke treated in this case and what was the recovery period?

Doctor’s Tip

A doctor may advise a patient considering pediatric scoliosis surgery to be aware of the potential risk of stroke, although it is rare. They may recommend closely monitoring for any unusual symptoms such as sudden weakness, numbness, or difficulty speaking, and seeking immediate medical attention if these occur. Additionally, they may suggest discussing with the surgical team any specific factors that may increase the risk of complications, and following post-operative care instructions carefully to reduce the risk of potential complications.

Suitable For

Pediatric scoliosis surgery is typically recommended for patients who have a curvature of the spine that is severe and progressive, causing pain, breathing difficulties, or affecting their quality of life. Surgery may be considered for patients who have:

  • Curves that are greater than 40-50 degrees and are still growing, especially in younger children
  • Curves that are causing significant pain or discomfort
  • Curves that are affecting the patient’s ability to breathe properly
  • Curves that are affecting the patient’s appearance or self-esteem

It is important for patients and their families to discuss the risks and benefits of surgery with their healthcare provider to determine if surgery is the best course of action for their specific case. In some cases, non-surgical treatments such as bracing or physical therapy may be recommended first to see if they can help manage the scoliosis without the need for surgery.

Timeline

Before pediatric scoliosis surgery:

  1. Patient is diagnosed with scoliosis, a condition characterized by an abnormal curvature of the spine.
  2. Patient undergoes various imaging tests such as X-rays and MRIs to assess the severity of the curvature.
  3. Treatment options are discussed with the patient and their family, including the possibility of surgery for severe cases.
  4. Pre-operative preparations are made, including medical evaluations, physical therapy, and counseling to prepare the patient for surgery.
  5. Patient and their family receive education on the surgical procedure, potential risks and complications, and post-operative care.

After pediatric scoliosis surgery:

  1. Patient undergoes the surgical procedure to correct the curvature of the spine, which may involve spinal fusion, instrumentation, or other techniques.
  2. Patient is closely monitored in the recovery room for any immediate post-operative complications.
  3. Patient is transferred to the pediatric intensive care unit (PICU) or a regular hospital room for further monitoring and pain management.
  4. Patient begins physical therapy and rehabilitation to regain strength and mobility in the spine.
  5. Patient is discharged from the hospital once they are stable and able to continue their recovery at home.
  6. Patient continues to follow up with their healthcare team for regular check-ups and monitoring of their spine curvature.
  7. Patient may experience complications such as infection, nerve damage, or, as in the case mentioned above, a stroke, which requires immediate medical attention and treatment.
  8. Patient gradually resumes normal activities and returns to school and other daily routines as their spine heals and strengthens.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric scoliosis surgery, including the risk of stroke?

  2. What steps will be taken during the surgery to minimize the risk of stroke or other complications?

  3. How will my child be monitored for signs of stroke or other potential complications during and after the surgery?

  4. What is the expected recovery process following pediatric scoliosis surgery, and how long will it take for my child to fully recover?

  5. What follow-up appointments and tests will be necessary to monitor my child’s recovery and ensure that there are no complications?

  6. Are there any specific warning signs or symptoms that I should watch for at home that may indicate a potential complication, such as a stroke?

  7. What is the plan for managing pain and discomfort after the surgery, and what medications will be prescribed for pain management?

  8. Are there any lifestyle changes or restrictions that my child will need to follow during the recovery period, such as limitations on physical activity or lifting heavy objects?

  9. How will the surgery impact my child’s long-term health and quality of life, and what can we do to optimize their recovery and overall well-being?

  10. Are there any alternative treatment options or approaches that should be considered before proceeding with surgery for pediatric scoliosis?

Reference

Authors: Egea-Gámez RM, Galán-Olleros M, González-Díaz R. Journal: Spine Deform. 2022 Sep;10(5):1209-1214. doi: 10.1007/s43390-022-00516-6. Epub 2022 May 14. PMID: 35562632