Featured Research

from universities, journals, and other organizations

Modern surgery for scoliosis has good long-term outcomes, study shows

Date:
April 5, 2011
Source:
Hospital for Special Surgery
Summary:
Teenagers who undergo spine fusion for scoliosis using the newest surgical techniques can expect to be doing well 10 years after surgery, according to a new study. Researchers had thought that the surgery would cause damage to the spine just below the fused discs, but the study showed that this was not the case.

Daniel Green, M.D., pediatric orthopedic surgeon at Hospital for Special Surgery, examines images showing fusion for adolescent idiopathic scoliosis using the newer generation spine implants.
Credit: Hospital for Special Surgery

Teenagers who undergo spine fusion for scoliosis using the newest surgical techniques can expect to be doing well 10 years after surgery, according to a Hospital for Special Surgery study published online ahead of print in the [TK issue] of the journal Spine. Researchers had thought that the surgery would cause damage to the spine just below the fused discs, but the study showed that this was not the case.

"Fusion for adolescent idiopathic scoliosis using the newer generation spine implants appears to spare junctional disc degeneration and allows patients ten years out to have a relatively normal pain free lifestyle," said Daniel Green, M.D., a pediatric orthopedic surgeon at Hospital for Special Surgery in New York who led the study.

Scoliosis is a condition in which a person's spine is curved. The condition can be classified as congenital (caused by vertebral anomalies present at birth), idiopathic (arising after birth and caused by unknown factors) or neuromuscular, where it is a secondary symptom of another condition such as spina bifida. Starting in the early 1960s and up until the late 1990s, scoliosis was treated with surgery with so-called Harrington rods that were implanted along the spinal column. Starting in the late 1990s, surgeons started using newer techniques to fuse the spinal column together and these straight rods became obsolete. Spinal fusion is basically a procedure where doctors "weld" parts of the spine together, so the vertebral column heals into a single, solid rigid unit.

The modern surgery is superior to the Harrington rods surgery because it allows the spine to be corrected in a much more natural, physiologic way, but there haven't been many studies evaluating how patients who undergo the surgery fare years down the road. To remedy this, HSS investigators conducted a pre- and post-operative MRI analysis in patients undergoing the surgery with modern techniques.

The investigators reviewed all spinal fusions performed by four senior scoliosis surgeons at HSS between 1991 and 1997. Patients were included in the study if they had idiopathic scoliosis, were 21 years or younger and had surgery that had the surgeon approach the patient's spine from the patient's back versus the front or side. Patients had to have fusion of the spine in their lower back (between vertebra T12 and L3).

Thirty-three potential study participants were located and 20 agreed to participate. These patients returned for a physical examination by an orthopedic surgeon that included an MRI. Doctors recorded their medical history with special attention to level and location of pain and whether or not the patient was taking pain medication. Doctors compared the new MRIs to the ones taken ten years prior, before the surgery.

"We wanted to see how the patients were doing ten years down the road, specifically focusing on the part of the spine that didn't have surgery. The standard belief was that the area of the spine just below the surgery would wear out, because of the increased stress that the surgery or the fusion would put on that part of the spine," Dr. Green said. "That isn't what we found. We found that the area of the spine adjacent to the fusion was pretty healthy and didn't show any major degeneration ten years later. While mild degenerative changes were noted in almost every patient, the severe changes that we were concerned that we might find were not there at all."

The investigators also found that patients had good functional scores and maintenance of balance. No patients reported significant lower back pain. No patients took analgesic medications for their pain, with the exception of four patients (20%) who took occasional non-prescription non-steroidal anti-inflammatory drugs.

The investigators say the study results are good news for patients. Dr. Green also said the results may cause worry for investigators and companies who are trying to develop surgeries for scoliosis that do not involve fusing the spine. "There is a lot of research and investment being done looking for new technologies that do not use fusion," Dr. Green said. "This study would suggest that there is a challenge for those trying to do that because the patients doing fusion are doing well."

Other Hospital for Special Surgery authors of the study are Thomas Lawhorne, M.D., Roger Widmann, M.D., Christopher Kepler, M.D., Caitlan Ahern, Douglas Mintz, M.D., Bernard Rawlins, M.D., Stephen Burke, M.D., and Oheneba Boachie-Adjei, M.D.


Story Source:

The above story is based on materials provided by Hospital for Special Surgery. Note: Materials may be edited for content and length.


Journal Reference:

  1. Daniel W. Green, Thomas W. Lawhorne, Roger F. Widmann, Christopher K. Kepler, Caitlin Ahern, Douglas N. Mintz, Bernard A. Rawlins, Stephen W. Burke, Oheneba Boachie-Adjei. Long Term MRI Follow-up Demonstrates Minimal Transitional Level Lumbar Disc Degeneration after Posterior Spine Fusion for Adolescent Idiopathic Scoliosis. Spine, 2011; 1 DOI: 10.1097/BRS.0b013e3181ff1ea9

Cite This Page:

Hospital for Special Surgery. "Modern surgery for scoliosis has good long-term outcomes, study shows." ScienceDaily. ScienceDaily, 5 April 2011. <www.sciencedaily.com/releases/2011/04/110405093654.htm>.
Hospital for Special Surgery. (2011, April 5). Modern surgery for scoliosis has good long-term outcomes, study shows. ScienceDaily. Retrieved October 20, 2014 from www.sciencedaily.com/releases/2011/04/110405093654.htm
Hospital for Special Surgery. "Modern surgery for scoliosis has good long-term outcomes, study shows." ScienceDaily. www.sciencedaily.com/releases/2011/04/110405093654.htm (accessed October 20, 2014).

Share This



More Health & Medicine News

Monday, October 20, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

How Nigeria Beat Its Ebola Outbreak

How Nigeria Beat Its Ebola Outbreak

Newsy (Oct. 20, 2014) The World Health Organization has declared Nigeria free of Ebola. Health experts credit a bit of luck and the government's initial response. Video provided by Newsy
Powered by NewsLook.com
Another Study Suggests Viagra Is Good For The Heart

Another Study Suggests Viagra Is Good For The Heart

Newsy (Oct. 20, 2014) An ingredient in erectile-dysfunction medications such as Viagra could improve heart function. Perhaps not surprising, given Viagra's history. Video provided by Newsy
Powered by NewsLook.com
Ebola Worries End for Dozens on U.S. Watch Lists

Ebola Worries End for Dozens on U.S. Watch Lists

Reuters - US Online Video (Oct. 20, 2014) Forty-three people who had contact with Thomas Eric Duncan, the first person diagnosed with Ebola in the U.S., were cleared overnight of twice-daily monitoring after 21 days of showing no symptoms. Rough Cut (no reporter narration). Video provided by Reuters
Powered by NewsLook.com
Fauci: Ebola Protocols to Focus on Training

Fauci: Ebola Protocols to Focus on Training

AP (Oct. 20, 2014) Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, says he expects revised CDC protocols on Ebola to focus on training, observation and ensuring health care workers are more protected. (Oct. 20) Video provided by AP
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins