April 3rd 5th 2008. Prospective controlled studies on in-patient rehabilitation and bracing [125127] and consistent results in retrospective studies [7] justify the recommendation of at least grade B research [128]. Crigger NJ, Meek VL: Toward a theory of self-reconciliation following mistakes in nursing practice. 10.1097/00007632-199307000-00017. Cases of scoliosis in the elderly typically arise due to one of three reasons. J Pediatr Orthop B. Spinal Deformity Surgery : It Becomes an Essential Part of Neurosurgery. 10.1097/00007632-200207010-00016. It is recommended to stop smoking at least four weeks prior to surgery to mitigate complications. 1995 Jul 15; Smith PL, Donaldson S, Hedden D, Alman B, Howard A, Stephens D, Wright JG: Parents' and patients' perceptions of postoperative appearance in adolescent idiopathic scoliosis. Sarwahi V, Sarwark JF, Schafer MF, Backer C, Lee M, King EC, Aminian A, Grayhack JJ: Standards in anterior spine surgery in pediatric patients with neuromuscular scoliosis. A retrospective analysis of 45 cases. D'Souza R, Doshi A, Bhojraj S, Shetty P, Udwadia Z: Massive pleural effusion as the presenting feature of a subarachnoid-pleural fistula. This is due to problems in reporting such as; mandatory reporting, definitions, interpretation of complications and compliance varies [32]. Purpose The Morbidity and Mortality (M&M) report of the Scoliosis Research Society (SRS) has been collected since 1965 and since 1968 submission of complications has been required of all members. Another reason so many cases of AIS go undiagnosed is because scoliosis is rarely a painful condition while the spine is still growing; this is why its not uncommon for these cases to go undiagnosed, until the patient reaches skeletal maturity and can feel that something isnt right. 10.1007/s00264-004-0599-1. 2007 Sep 1; Dolan LA, Donnelly MJ, Spratt KF, Weinstein SL: Professional opinion concerning the effectiveness of bracing relative to observation in adolescent idiopathic scoliosis. 10.1097/00004694-199701000-00023. This can provide pain relief, improve breathing for those with lung compression, and improve cosmetic appearance for those with severe curvatures. The surgeon will determine if medications that cause increased bleeding should be continued or stopped depending on the medical situation of each patient. Journal of Pediatric Orthopedics. 10.1097/01.brs.0000162284.38214.53. 26 (4): 448-50. That said, the overall death rate from scoliosis surgery is thought to be . 2006 May 11; Weiss HR: Rehabilitation of adolescent patients with scoliosis what do we know? 11 papers reported on the rate of complication in patients with scoliosis of mixed aetiologies [88, 188197] and one in patients after re-operation [198]. Journal of Bone and Joint Surgery. Experts agree that children with spine curvatures of 45 to 50 degrees will need surgery to reduce the curve and prevent further curvature over time. Z Orthop Ihre Grenzgeb. Surgical treatment for scoliosis. shortness of breath). No data in support of this observation is provided. 2006, 15 (7): 1108-17. Unfortunately in the years 1994 to 2005, there is a varying percentage of SRS members submitting data, ranging from 35 to 70% (SRS 2005 M & M data abstract [251]). Hawes M: Impact of spine surgery on signs and symptoms of spinal deformity. Spine. 10.1007/s002470050026. 2004 Feb 1; Merola AA, Haher TR, Brkaric M, Panagopoulos G, Mathur S, Kohani O, Lowe TG, Lenke LG, Wenger DR, Newton PO, Clements DH, Betz RR: A multicenter study of the outcomes of the surgical treatment of adolescent idiopathic scoliosis using the Scoliosis Research Society (SRS) outcome instrument. Scoliosis Surgery: Potential Risks and Complications Double major curvatures are compensated; the most stable curves present after the end of growth [4] and therefore rarely requiring surgical treatment. 1998, 84 (3): 224-30. In principle, all kinds of complications may occur in all scoliosis aetiologies [24]. 2001 Apr 1; Kahanovitz N, Brown JC, Bonnett CA: The operative treatment of congenital scoliosis. Scoliosis mortality rates in adults range from 2.5 to 3.3%, while adolescent mortality rates range from.03 to. Spine. Al-Binali AM, Sigalet D, Goldstein S, Al-Garni A, Robertson M: Acute lower gastrointestinal bleeding as a late complication of spinal instrumentation. Trials with untreated control groups in the field of scoliosis raise ethical issues, as the control group could be exposed to the risks of undergoing such surgery. 1998, 80-A: 722-724. Typical forms of the condition are not known to cause death, even if left untreated; however, more severe forms that develop in conjunction with other serious medical issues, such as neuromuscular scoliosis, can have less than favorable outcomes. In view of the fact that there is no evidence that health related signs and symptoms of a scoliosis can be changed by spinal fusion in the long-term [24, 130134], a clear medical indication cannot be derived from most scoliosis conditions [129, 131134]. There were 17 deaths (0.3%). AIS has been classified according to specific curve patterns and these patterns clinically may appear more or less pronounced (Figure 1). Journal of Spinal Disorders & Techniques. 1948, Ann Arbor: The American Academy of Orthopaedic Surgeons, 5: 261-75. 10.1097/00007632-200305150-00028. Brown JC, Zeller JL, Swank SM, Furumasu J, Warath SL: Surgical and functional results of spine fusion in spinal muscular atrophy. What specific evidence is there to support scoliosis surgery? Difficulty swallowing, sometimes accompanied by gagging, choking and vomiting. Welcome to Scoliosis Reduction Center. Clin Orthop Relat Res. 2001 Sep 15; Marchesi DG, Aebi M: Pedicle fixation devices in the treatment of adult lumbar scoliosis. Spinal deformity surgery in adults is particularly complicated. Experience from the Ste-Justine Hospital, Montreal]. 1998, London, Boston Singapore, Sydney, Toronto, Wellington: Wright Press. Further prospective studies including these parameters will be required to determine the real benefit of such procedures to the patient [24]. Other risks of scoliosis surgery are summarised below. SF-36 and Roland questionnaires assessment. 10.1053/jpsu.2001.21623. 1997, 22: 1760-1764. Rate of complications in scoliosis surgery - a systematic review of the Risks of spinal fusion include those occurring in any major surgery, such as severe blood loss; urinary infections due to catheterization; pancreatitis; and obstructive bowel dysfunction due to immobilisation during and after surgery [2531]. 10.1097/00007632-200003010-00010. Object Currently, few studies regarding morbidity and mortality associated with operative treatment of spinal disorders in children are available to guide the surgeon. 2001, 21 (1): 117-25. The rate of complications may even be higher than reported. 287 titles have been found when the term "rate of complications" was used as a key word. An IV (intravenous catheter) will be placed to provide any medications that will be needed during surgery. There was no cosmetic/psychological benefit in this case and therefore this surgery should perhaps not have been performed. The paper by Martha Hawes [24] contains very comprehensive accounts of the reported complications of scoliosis surgery until early 2006. The gold standard for surgical treatment of scoliosis is spinal fusion surgery. Jounal of Pediatric Surgery. 10.2106/JBJS.F.01389. 1989, 14 (7): 763-70. While I specialize in a functional scoliosis treatment approach, the traditional treatment approach that funnels patients towards spinal-fusion surgery carries potential for additional risks and complications, including infection and death. Spine. Banit DM, Iwinski HJ, Talwalkar V, Johnson M: Posterior spinal fusion in paralytic scoliosis and myelomeningocele. Can Scoliosis Surgery Kill You? - Scoliosis Care Centers The electronic search carried out on the 1st February 2008 with the key words "scoliosis", "surgery", "complications" revealed 2590 titles, which not necessarily attributed to our quest for the term "rate of complications". The purpose of this review is to present the actual data available on the rate of complications in scoliosis surgery. Chirurgie. 10.1097/00004694-199911000-00014. Spine. Farley FA, Caird MS: Pancreatitis after posterior spinal fusion for AIS. Most patients are discharged from the hospital after four days. 1996, 5: 380-386. Bridwell [10] suggests that late-developing pain could be a complication of surgery, or an effect of aging, or 'perhaps a focus on the disability associated with spinal deformity and surgical treatment.' The muscles are moved aside to expose the vertebrae of the spine. 1998, 23: 1356-1361. Spine. Pros And Cons Of Scoliosis Surgery For Adults - Know How Community Spine. Many thanks to Lesley Schneider for proof reading and correcting the final manuscript. 2007 Oct 15; Mohamad F, Parent S, Pawelek J, Marks M, Bastrom T, Faro F, Newton P: Perioperative complications after surgical correction in neuromuscular scoliosis. Additionally to that not all types of complications are registered like many of those described in the introduction of this paper. 27 (18): 2046-51. Spinal fusion surgery takes place in a hospital operating room with a surgical team consisting of a surgeon, resident, physician assistant, or nurse practitioner, surgical nurses, scrub technologists, and an anesthesia team to monitor the patient under general anesthesia. Due to such complications outlined above more re-operation is necessary, sometimes referred to as 'reconstructive,' 're-corrective,' 'revision,' or 'salvage' surgery [115]. Spine. Rizzi PE, Winter RB, Lonstein JE, Denis F, Perra JH: Adult spinal deformity and respiratory failure. 2004, 100: 1308-1310. Developmental Medicine and Child Neurology. Spine. 27 (14): 1543-50. 10.1097/00007632-200102150-00024. Physical therapists work with people to resume activities of daily living such as walking and moving from the bed to a chair. Emami A, Deviren V, Berven S, Smith JA, Hu SS, Bradford DS: Outcome and complications of long fusions to the sacrum in adult spine deformity: luque-galveston, combined iliac and sacral screws, and sacral fixation. 31 (14): E441-7. Similar Cobb angles clinically may look different depending on curve pattern. J Pediatr Orthop. 10.1002/mus.880150512. 10.1097/00007632-199806150-00012. Journal of Pediatric Orthopedics. Objective. Google Scholar. Klemme WR, Burkhalter W, Polly DW, Dahl LF, Davis DA: Reversible ischemic myelopathy during scoliosis surgery: a possible role for IV lidocaine. European Spine Journal. Brown JC, Swank S, Specht L: Combined anterior and posterior spine fusion in cerebral palsy. Everyone who has scoliosis will not automatically be scheduled for surgery. Int Orthop. Journal of Spinal Disorders. Journal of Trauma, Injury, Infection, Critical Care. Proceedings of the 5th. In the light of an actual publication on adolescent idiopathic scoliosis with a prospective design [135], showing the short-term risks of scoliosis surgery to be more than 3 times higher than previously expected from retrospective reviews, the matter of surgical indications at present should be investigated more closely in order to improve the patient's safety. 1997, 22: 58-67. Balanced appearance with marked rib-hump after surgery. (Figure 5). Scoliosis and Spine Associates. J Bone Joint Surg Am. Cummings RJ: Recurrent meningitis secondary to infection after spinal arthrodesis with instrumentation. 1988, 37: 597-599. 10.1097/00007632-199807010-00015. 10.1097/00003086-199602000-00015. 25 (6): 696-702. Journal of Pediatric Orthopedics. Rates of complication varied between 0 and 89% depending on the aetiology of the entity investigated. 1996, 76-A: 839-847. 1991, 16: S404-S408. 1988, 19: 257-269. Bago J, Ramirez M, Pellise F, Villanueva C: Survivorship analysis of Cotrel-Dubousset instrumentation in IS. 1998, 23: 324-331. An 'excellent radiological result' one year after ventral fusion. 10.1007/s005860000186. The vertebrae are roughened up to promote bone growth and fusion. 10.1097/00007632-200010010-00006. As the goal of spinal fusion is to stop progression, this eliminates movement in the fused portion of the spine. Journal of Pediatric Orthopedics. Cobb JR: Outline for the study of scoliosis. 10.1097/00007632-198211000-00010. 2002 Sep 15; Asher M, Min Lai S, Burton D, Manna B: The reliability and concurrent validity of the scoliosis research society-22 patient questionnaire for idiopathic scoliosis. Bradford DS, Tay BK, Hu SS: Adult scoliosis: surgical indications, operative management, complications and outcomes. One paper included patients with early onset scoliosis [186] and one included patients with congenital heart disease [187]. [http://www.hpnonline.com/inside/2006-05/HPNonline.com-%20Clinical%20Business%20Strategies%20-%200605.html], The New York Times Medtronic to Pay $1.35 Billion to Inventor. Weinstein SL, Dolan LA, Spratt KF, Peterson KK, Spoonamore MJ, Ponseti IV: Health and function of patients with untreated idiopathic scoliosis: A 50 year natural history study. 2007, 27 (4): 392-7. 2001 Apr 15; Simmons ED, Kowalski JM, Simmons EH: The results of surgical treatment for adult scoliosis. Based on primary diagnosis (available for 107,996 patients), rates of death per 1000 patients were as follows: 0.9 for degenerative (n = 47,393), 1.8 for scoliosis (n = 26,421), 0.9 for spondylolisthesis (n = 11,421), 5.7 for fracture (n = 6706), 4.4 for kyphosis (n = 3600), and 3.3 for other (n = 12,455). Exclusion and inclusion criteria for the selection of studies in this review. Spinal fusion for scoliosis is considered an elective procedure. In the majority of cases, the causes are unfortunately unknown and have come to be known as having 'idiopathic' scoliosis [3]. 1941, 23-A: 963-99741. Scoliosis J Spinal Disord. LaGrone MO: Loss of lumbar lordosis; a complication of spinal fusion for scoliosis. Spine. 2001, 26: 1778-1787. Eur Spine J. The spine's normal curves occur at the cervical, thoracic and lumbar regions in the so-called "sagittal" plane. 10.1097/01.brs.0000224176.40457.52. 2012;147(4):373383. Congenital scoliosis is no uniform condition as well. The specific choice of these has been reviewed recently [2123]. Beginning with Harrington rods, surgeons have experimented with instrumentation of increasing complexity and bulk to hold spinal fusions in place [24]. Spine. 1995, Philadelphia, W.B. Spine. [http://www.nytimes.com/2005/04/23/business/23medronic.html?ex=1271908800&en=f2b6a791c937140a&ei=5090&partner=rssuserland&emc=rss], The New York Times The Spine as Profit Center. Respiration. Due to advances in surgery the number of scoliosis curves greater than 100 had dropped considerably by 1973 . Sucato DJ, Girgis M: Bilateral pneumothoraces, pneumomediastinum, pneumoperitoneum, pneumoretro-peritoneum, and subcutaneous emphysema following intubation with a double-lumen endotracheal tube for thorascopic anterior spinal release and fusion in a patient with IS. Once an adolescent with scoliosis reaches skeletal maturity in adulthood, their condition can start to become painful. 32 (24): 2759-63. Sponseller PD, LaPorte DM, Hungerford MW: Deep wound infections after neuromuscular scoliosis surgery. Early-Onset Scoliosis Surgery Has High Risk of Mortality, Morbidity 2001 Oct 1; Padua R, Padua S, Aulisa L, Ceccarelli E, Padua L, Romanini E: Patient outcomes after Harrington instrumentation for idiopathic scoliosis: a 15- to 28-year evaluation. 10.1097/00002517-198803000-00006. The adult population may consist of adult patients with idiopathic scoliosis or of patients with degenerative deformity. Pediatr Rehabil. Wood KB, Schendel MJ, Dekutoski MB, Boachie-Adjei O, Heithoff KH: Thoracic volume changes in scoliosis surgery. 10.1097/00004694-200111000-00010. With any type of diagnosis, often one of the first thoughts is, Can this kill me? The same can be said of someone who receives a scoliosis diagnosis; they are also going to naturally wonder if the condition can kill them. Sweet FA, Lenke LG, Bridwell KH, Blanke KM, Whorton J: Prospective radiographic and clinical outcomes and complications of single solid rod instrumented anterior spinal fusion in adolescent idiopathic scoliosis. 10.1097/00007632-199108001-00019. 10.1097/00002517-199106000-00002. Privacy Journal of Bone and Joint Surgery. JAMA. 10.1007/s00586-006-0147-3. Clinical Orthpedics and Related Research. Clin Orthop Relat Res. 2007, 90 (1): 96-105. Nuttall GA, Horlocker TT, Santrach PJ, Oliver WC, Dekutoski MB, Bryant S: Predictors of blood transfusions in spinal instrumentation and fusion surgery. 1999, 124 (4): 423-31. 2001, 120: 3261-3263. Weiss HR, Goodall D: Treatment of Adolescent Idiopathic Scoliosis (AIS) according to present evidence. Clinical Orthopedics and Related Research. 2003, 26: 515-516. 10.1007/s00586-004-0694-4. Arlet V, Marchesi D, Papin P, Aebi M: Decompensation following scoliosis surgery: treatment by decreasing the correction of the main thoracic curve or 'letting the spine go'. Spine. 10.1007/s005860050147. This paradoxical trend may be well understood when applying Cognitive Dissonance Theory. J Bone Joint Surg Am. Edited by: Lonstein, J, Bradford D, Winter R, Oglivie J. 10.1007/s00586-005-0034-3. There is no definitive answer to this question as the death rate from scoliosis surgery can vary depending on a number of factors, including the severity of the scoliosis, the age and health of the patient, and the experience of the surgeon. 1999, 8: 156-159. Edited by: Lonstein, J, Bradford D, Winter R, Oglivie J. Report of the Research Committee of the American Orthopedic Association. Not the best clinical result with patient satisfaction. Eur Spine J. Weiss HR, Negrini S, Hawes MC, Rigo M, Kotwicki T, Grivas TB, Maruyama T, members of the SOSORT: Physical exercises in the treatment of idiopathic scoliosis at risk of brace treatment SOSORT consensus paper 2005. The post surgical rigid spine causes strain on the un-fused parts of the skeletal framework [5459] and in a severe case, a woman sustained stress fractures to the pelvis [61]. If this study had included individuals with low back pain, the incidence of scoliosis might have been even higher. 2000, 9 (Suppl 1): 17-23. Among 74 patients treated surgically between 1961 and 1976, pseudarthrosis occurred in 27% of patients within a few years of surgery [88]. Such injuries can cause a range of complications, from transient neuropraxias related to body position to spinal cord damage that causes total paralysis. Rates, causes of spinal surgery-tied mortality quantified - Medical Xpress 10.1097/00007632-200010010-00007. 10.1007/s002470050308. 1988, 1 (3): 211-8. 1997 Oct 1; Yu B, Zhang JG, Qiu GX, Wang YP, Yang XY: Video-assisted thoracoscopic correction and fusion of scoliosis. 2005, 91 (4): 314-27. While death is not a common complication of scoliosis surgery, it does occur and is more common than a person dying from an abnormal spinal deformity on its own. 2002, 27: E337-E341. The Risks Of Scoliosis Surgery: A New Study - Brandon Orthopedics Z Orthop Ihre Grenzgeb. Can Scoliosis Kill You? 2018 Nov;61(6):661-668. doi:10.3340/jkns.2018.0150, Srensen LT. 1997, 22: 1668-1672. 2002, 27: 2363-2367. In addition to the monetary cost of surgery, it comes with other high costs such as loss of flexibility in the spine, and the psychological effects of living with a fused spine. 1999, 99-107. 31 (26): 3018-26. The pooled rate of major complications is listed on table 2 and the list of complications found within the reviewed papers can be seen on table 3 and 4. Behensky H, Krismer M, Bauer R: Comparison of spinal mobility after Harrington and Cotrel-Dubousset instrumentation. A good indicator of just how serious a condition is is what happens if it's left untreated. She works as a freelance content writer for healthcare blogs when she's not spending time with her husband and dog. Spine. 10.1097/00007632-200103010-00016. Verywell Health's content is for informational and educational purposes only. Surgery is impossible to reverse, but subjective beliefs and public attitude can be altered more easily. 22 (19): 2239-45. 2005, 29 (1): 47-50. 10.1017/S0012162203001269. Tympanoplasty Surgery: Everything You Need to Know, Spinal Fusion Surgery: Everything You Need to Know, Halo Vest vs. Spinal Fusion: Uses, Benefits, Side Effects, and More, Sciatica Surgery: Everything You Need to Know, Spinal Deformity Surgery : It Becomes an Essential Part of Neurosurgery, Wound Healing and Infection in Surgery:The Clinical Impact of Smoking and Smoking Cessation: A Systematic Review and Meta-analysis, An elderly person who would not survive the surgery due to age, chronic conditions, or length of time under general anesthesia, Nerve injury as minor as numbness or as severe as paralysis (nerve functioning will be monitored throughout the procedure to alert the surgeon of any nerve changes occurring at that specific moment of the surgery), Excessive bleeding depending on the number of bones being worked on during the procedure (this will also be monitored and contained throughout the surgery), Broken hardware or fracture of the vertebrae around the hardware. 10.1007/s00247-002-0659-x. 32 (26): E841-4. Anesthesiology. Predictors of outcome. Rates and Causes of Mortality Associated With Spine Surgery - LWW It can be performed on children, teenagers, or adults following unsuccessful nonsurgical treatments. 2007, 2: 19-10.1186/1748-7161-2-19. Proceedings, Scoliosis Research Society 36th Annual Meeting, Cleveland OH. 2000, 30: 110-118. Winter RB: Flail chest secondary to excessive rib resection in IS: case report. A medical indication for this treatment cannot be established in view of the lack of evidence. Patients will remove their clothes and jewelry, and change into a surgical patient gown. with complications not due to scoliosis surgery. 1995, 120 (11): 1994-26. To conclude from single case reports that; "the early fusion prevented the customary severe progression of this condition and early death due to cor pulmonale" [220, 221], seems biased when there could be the possibility that even without surgery cor pulmonale would not necessarily be the consequence of an untreated congenital scoliosis. As highlighted by Hawes [24], the complexity of spinal surgery is reflected in the diversity of complications that may result months or years later. One study found scoliosis to be present in 68% of healthy individuals over the age of 65 with no low back pain. Acta Orthopaedica Scandinavica. Copyright 2022 - Scoliosis Reduction Center. The definition of major and minor complications also varies in these studies. The complexity of spinal surgery is reflected in the diversity of complications that may occur months or years later. Children who have very mild curves usually don't need any treatment at all, although they may need regular checkups to see if the curve is worsening as they grow. 3 January 2007. 10.1055/s-2002-34007. All patients on this figure have a Cobb angle of 40 degrees. Roush TF, Crawford AH, Berlin RE, Wolf RK: Tension pneumothorax as complication of video-assisted therascopic surgery for anterior correction of IS in an adolescent female. Lonstein JE: Idiopathic scoliosis. 1999 Jan 15; Winter RB, Lonstein JE: Congenital thoracic scoliosis with unilateral unsegmented bar and concave fused ribs: rib osteotomy and posterior fusion at 1 year old, anterior and posterior fusion at 5 years old with a 36-year follow-up. 2005 Sep 1; Coran DL, Rodgers WB, Keane JF, Hall JE, Emans JB: Spinal fusion in patients with congenital heart disease. Orthopedic Clinics of North America. Spine. Just recently, new papers on this topic appeared [130, 135] and in the light of recent discussions about the specific indications for scoliosis surgery [130132], a review on this topic seems desirable. What to know about spinal fusion surgery for scoliosis - Medical News Today A rigid fusion of the spinal bones prevents further growth in the section of abnormal spine and keeps the curve from getting worse.