Scoliosis Surgery - Risks of Refusing Fusion Surgery for Adolescent Idiopathic Scoliosis Overstated

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Severe scoliosis can present problems in cardiopulmonary function. The definition of severe scoliosis varies depending on sources. Most authors consider 60-degree standard for scoliosis is called severe. As for the crushing of internal organs, most of the current literature states that it is very rarely less than 1%, and only in cases of over 100 degrees. There are two major factors that go into deciding whether or not to take your child to undergo a spinal fusion operacije.Prvi the aesthetic look that most orthopedic surgeons say the number one concern of patients and their parents before learning potential cardiopulmonary učinak.Drugi the fear of health problem not only in the immediate future, but down the road.

This fear is probably based on a conversation with his orthopedic doctor regarding scoliosis and harmful impact on the cardiopulmonary system. Most often in my experience, in consultation with parents of children who are progressing scoliosis is that their understanding of "risk" is that if they do not have the surgery are putting your child at significant risk of health problems and potentially death. I think it is very important to discuss this mindset before entering into something that will change your life forever child.

There are several parameters that are often not discussed with the parents that would indicate a higher risk compared to almost no rizika.Istraživanja convincingly show that the increased risk of lung function loss resulting from structural thoracic scoliosis with Cobb measurements more than 60 degrees in the frontal plane and a significant loss of normal kyphosis in the sagital plane of 50% or more. According to the Lenke classification would be a subcategory of about 18% of patients with AIS to get a surgical threshold is 50 degrees.

curves with apexes below T9 generally do not have any restrictive lung problems, because there is no deformity of the chest, a much lower spine rigidity. Thoracic curves with apexes more than T7 have also been excluded. Primary structural thoracic scoliosis with normal to slightly reduced kyphosis are also questionable. So it would be very unlikely that we could say that "all" children with large curves will have any kind of damage to lung function loss.

Therefore, each child does not show a measurable decline in lung function should not be subjected to by medical necessity and justification should be thoroughly aware of the procedure for cosmetic appearance only of the process is not correcting the existing loss functions but the medical assumption that they are correcting a potential problem. So I should have my kidney removed because it looks abnormal on ultrasound and MRI, but all of my kidney tests are normal Hmmm.

other issues currently being debated is whether or not scoliosis surgery actually improves pulmonary function in adolescent idiopathic scoliosis. They agreed that it was undoubtedly a short-term effects are significantly reduced lung function, but long-term studies are certainly inconclusive.

conclusions. Pulmonary function after thoracotomy with ASA instruments showed a significant decline from 3 months postoperative PFT values, but returned to the preoperative absolute value of the basic 2-year follow-up visits. percent of predicted values ​​returned to within 95% of the primary two years postoperatively. Scoliosis surgeons should be aware of these findings when deciding on the approach. Spine 2000; 25:2319-2325

Notice of lung function returned to preoperative levels after two years, but scoliosis surgery did not improve lung function.

conclusions - forced vital capacity was reduced to long track in adult patients with idiopathic scoliosis who undergo anterior spinal surgery. Decline in FVC is small and is unlikely to be of clinical significance in patients with reasonable lung function in whom surgery is planned for the prevention of progression of the curve and improve cosmetic appearance and pain. However, surgical intervention should be undertaken in an attempt to improve lung function (Thorax 1996, 51:534-536).