Scoliosis Surgery Statistics You Won't Find in Your Surgeon's Waiting Room

Scoliosis Surgery Statistics You Won't Find in Your Surgeon's Waiting Room Everyone agrees that surgery for scoliosis is a highly invasive procedure that should be utilized as a last resort treatment option once all other treatment options have been exhausted. The surgical correction procedure involves large incisions, lots of blood loss, multiple level spinal fusions, extensive surgical hardware, and completely altered spinal bio-mechanics for life.

It is not a decision that should be taken lightly (and I’m not suggesting that anyone is), but the decision to undergo scoliosis surgery should also be discussed with an appropriate time frame in which this decision may have effects on the patient, namely their entire lifetime.

By in large, many surgically treated scoliosis patients are doing well 6 to 18 months after the procedure. Post-surgical site infections are rare and the amount of blood loss is mitigated with the patient’s own pre-surgical blood transfusion collections, but the rate of complications begins to rise significantly the longer the time frame one track data from on the time line from immediately after the surgical procedure over the course of the next 15-20 years.

Here are a few statistics you most likely won’t find in your orthopedic doctor’s waiting room •

“At an average of 45.7 months (range 11 to 142 months), 19 out of 40 patients (47.5%; including 2 patients with early revision) received late operative revisions.” o

Franz J Mueller1,2* and Herbert Gluch1. Cotrel-dubousset instrumentation for the correction of adolescent idiopathic scoliosis. Long-term results with an unexpected high revision rate. Scoliosis 2012, 7:13

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“40% of patients being legally defined as severely handicapped within 17 years post scoliosis surgery.”

Gotze C, Slomka A, Gotze HG, Potzl W, Liljenqvist U, Steinbeck J. Long-term results of quality of life in patients with idiopathic scoliosis after Harrington instrmentation and their relevance for expert evidence. Z Orthop Ihre Grenzgeb 2002 Sep-Oct;140(5):492-8

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“The psychological health status is significantly impaired.”

Quality of Life and Back Pain: Outcome 16.7 Years After Harrington Instrumentation Spine 2002 Jul 1;27 (13) :1456-63 Gotze et al, Dept. of O Surg, Hamm,Germany

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"Standardized gradations of pain and function showed improvement over-all, but significant impairment remained. There was a reduction in the levels of peak and constant pain, but no change in the frequency of peak pain after operation. The number of patients who were pain-free after surgery was not increased.....In view of the high rate of complications, the limited gains to be derived from scoliosis surgery should be assessed and clearly explained to patients before the procedure is undertaken."

Results of surgical treatment of adults with idiopathic scoliosis.

J Bone Joint Surg Am 1987 Jun;69(5):667-75 Sponseller PD, Cohen MS, Nachemson AL, Hall JE, Wohl ME.

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"The correlation between the change in Cobb angle and the thoracic volume change was poor for both groups."

Scoliosis curve correction, thoracic volume changes, and thoracic diameters in scoliotic patients after anterior and posterior instrumentation. Int Orthop 2001;25(2):66-0 While many will argue that patients with severe scoliosis have a very high risk of continued curve progression in adulthood (which they do) and spinal fusion surgery for scoliosis is necessary to halt the progression one last statistic comes to mind; "Initial average loss of spinal correction post-surgery is 3.2 degrees in the first year and 6.5 after two years with continued loss of 1.0 degrees per year throughout life."

It is clear that we are long overdue to find a better way to treat scoliosis that can prevent or replace multi-level spinal fusion surgery for scoliosis the sole treatment option for patients with severe scoliosis. I believe Paul Harrington, known for inventing the surgery that implants metal rods in scoliotic spines, said it best when he stated in 1963, "metal does not cure the disease of scoliosis, which is a condition involving much more than the spinal column�.