Our Summary

The research paper is about a study that looked at the risk of death and related risk factors in patients with specific neurological and muscular conditions (like cerebral palsy and muscular dystrophy) who had spine surgery due to early onset scoliosis, a condition where the spine curves to the side at a very young age. The study included 808 patients who had this surgery between 1994 and 2020.

The researchers found that there was no death in the first 30 days after the surgery. However, the risk of death increased over time, with 0.5% of patients dying within the first year, 1.1% within two years, 5.4% within five years, and 17.4% within ten years after the surgery.

The study identified several factors that increased the risk of death. These included having a diagnosis of cerebral palsy, being unable to walk, and needing help with breathing. However, the researchers pointed out that the increased death rate over time was likely not directly caused by the spine surgery itself, but rather by the severity of the patient’s underlying condition.

FAQs

  1. What is the risk of death for patients with neurological and muscular conditions who undergo surgery for early onset scoliosis?
  2. What factors were identified as increasing the risk of death after pediatric scoliosis surgery?
  3. Did the study suggest that the spine surgery itself directly caused the increased death rate over time?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pediatric scoliosis surgery is to ensure that the patient has a thorough understanding of the risks and benefits of the surgery, as well as realistic expectations for the outcomes. It is important for the patient and their family to work closely with the medical team to develop a comprehensive care plan that addresses the patient’s individual needs and potential complications. Regular follow-up appointments and ongoing monitoring of the patient’s condition are also crucial to ensure the best possible outcome.

Suitable For

Overall, pediatric scoliosis surgery is typically recommended for patients who have severe curvature of the spine that is causing pain, breathing difficulties, or impacting their quality of life. Patients with neurological and muscular conditions such as cerebral palsy and muscular dystrophy may also be recommended for surgery if their scoliosis is progressing rapidly and causing significant health issues.

It is important for healthcare providers to carefully assess each patient’s individual circumstances and overall health before recommending surgery, as the risks and benefits must be carefully weighed. In cases where surgery is recommended, close monitoring and post-operative care are crucial to ensure the best possible outcomes for the patient.

Timeline

Before pediatric scoliosis surgery, a patient typically undergoes a series of diagnostic tests such as X-rays, MRI, and physical exams to determine the severity of the scoliosis and assess the overall health of the patient. The patient may also participate in pre-operative appointments with the surgical team to discuss the procedure, potential risks, and post-operative care.

After pediatric scoliosis surgery, the patient will likely spend a few days in the hospital for recovery and monitoring. Pain management, physical therapy, and rehabilitation will be important components of the post-operative care plan. Follow-up appointments with the surgical team will be scheduled to monitor the patient’s progress and address any concerns that may arise.

Over time, the patient will continue to follow up with their healthcare team to ensure proper healing of the spine and monitor for any potential complications. Physical therapy and bracing may be recommended to support the spine and prevent further curvature. Long-term care will focus on maintaining spinal health and function to improve the patient’s quality of life.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric scoliosis surgery in general?

  2. How will the surgery specifically benefit my child’s condition and quality of life?

  3. How many pediatric scoliosis surgeries have you performed, and what is your success rate?

  4. What is the expected recovery time for my child after the surgery?

  5. Are there any alternative treatment options for pediatric scoliosis that we should consider before opting for surgery?

  6. How will my child’s neurological and muscular conditions, such as cerebral palsy or muscular dystrophy, impact the surgery and recovery process?

  7. What are the long-term outcomes and potential complications we should be aware of after the surgery?

  8. Are there any specific measures we can take to minimize the risks associated with pediatric scoliosis surgery for a child with neurological and muscular conditions?

  9. How will my child’s ongoing care and management be coordinated between their pediatrician, neurologist, and orthopedic surgeon after the surgery?

  10. Are there any support services available to help my child and our family navigate the emotional and practical challenges associated with pediatric scoliosis surgery and recovery?

Reference

Authors: Matsumoto H, Fano AN, Herman ET, Snyder B, Roye BD, Cahill P, Ramo B, Sponseller P, Vitale MG; Pediatric Spine Study Group. Journal: J Pediatr Orthop. 2022 Mar 1;42(3):e234-e241. doi: 10.1097/BPO.0000000000002036. PMID: 34939971