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My wife is going to have surgery to fuse at least a dozen vertebra for a bad case of scoliosis. I haven't wanted to ask in front of her, but what are the chances she'll have a good result from this surgery? I guess I'm really wondering what are the chances she won't recover from this procedure.
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There are lots of studies done on children and adolescents treated surgically for scoliosis. Reported results among adults are harder to come by. A recent prospective study from The Johns Hopkins University reported on information gathered and observed results as they treated and followed older adults having fusion surgery for scoliosis.
All of the patients were at least 40 years old. Most were women. None had a previous spinal fusion surgery. They all agreed to participate in the study for a minimum of two years to give an idea of final outcomes. Most were in good health but everyone had at least one other health problem such as high blood pressure, heart burn, osteoporosis, depression, anxiety, asthma, and so on.
The surgery consisted of fusing the spine at multiple levels (at least 10 levels up to as many as 20 segments). Some fusions went to the bottom of the lumbar spine (just above the sacrum) while others fused the last lumbar vertebrae to the sacrum.
Information gathered from the patients during that time included questions about general health and the presence of comorbidities (other problems). They also measured outcomes using patient level of satisfaction, function, need for additional (revision) surgery, and development of complications. Complications were divided into two groups: major (e.g., death, blood clots, fractures, deep wound infection) and minor (urinary tract infection, nerve palsy, lung or spleen puncture).
The fusion procedures were done with today's new technology and improved techniques and fixation devices. Devices used to fix (fuse) the bones in place included transsacral bars, alar screws, and iliac screws. This is the third-generation of instrumentation techniques -- meaning the third round of improvements in these devices.
Analysis of the results showed successful fusion rates but with a high rate of complications. Almost half (49 per cent) of the patients had at least one problem following surgery. Most of the complications were minor and occurred later after the patients went home. The more major complications presented early and required additional hospitalization. There were no deaths and no cases of permanent paralysis.
The majority of patients were very satisfied with their improved results and said they would have the surgery again if they had to do it over. In fact, patient satisfaction was equal among all patients regardless of whether or not they had complications. Both mental and physical health improved. Many of the patients were able to return to work after recovering.
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