6 Studies Supporting Timely Surgical Intervention for Appropriate Spine IndicationsWritten by Laura Miller | May 11, 2011
1. Kyphoplasty among fracture patients. New research suggests that performing kyphoplasty for patients who sustained vertebral fractures as a result of an injury decreases the likelihood of death by 44 percent, compared to patients who are prescribed bed rest and pain killers. The research was comprised of 410,965 patients who suffered fractures and received either surgical or non-surgical treatment. Of the patients who received surgical treatment, there was a 74.8 percent survival rate after 24 months, compared with the 67.4 percent among those who underwent non-surgical treatment.
The surgical patients were also less likely to die of fracture-related complications, and those who underwent kyphoplasty were more likely to survive than those who had vertebroplasty. The research was presented at the spring meeting of the British Geriatric Society.
2. Laminectomy soon after achondroplasia symptoms appear. Patients who receive surgery more quickly after experiencing achondroplasia symptoms report a better long-term functional outcome, according to a study published in Spine. Researchers examined 49 patients with achondroplasia who underwent primary laminectomy for spinal stenosis. Patients who waited an interval of less than six months to undergo surgery after symptoms appeared were 7.13 times more likely to report improvement in walking distance and four times more likely to experience Rankin level improvement than patients who waited longer than six months.
Patients who waited 12 and 24 months to undergo surgery also experienced improved walking distances compared to those who waited longer intervals, but no statistically significant difference in Rankin level was recorded. The average patient was 37.7 years old, and reported symptom duration of 74±100 months.
3. Timely surgical intervention for adolescent scoliosis. When children wait too long for scoliosis correction surgery, they are at higher risk for complication and may need additional surgery, according to a study published in the Canadian Medical Association Journal. The study followed 88 adolescent scoliosis patients who waited longer than six months and 128 patients who waited less than six months for surgical treatment. Of those who waited less than six months, 1.6 percent needed additional procedures, compared with the 15 percent who waited longer than six months for surgical intervention.
The study's authors suggested three months as the maximum wait time for patients with adolescent scoliosis who need surgical intervention to minimize the risk of complications and worsening curvature.
4. Benefits outweigh risks of surgery for adult scoliosis. The benefits of surgical intervention for patients with adult scoliosis outweigh the risks associated with the procedure in some cases, according to an article in Spine. For the study, researchers examined 260 patients who underwent surgical treatment for adult scoliosis and found that 17 percent of younger patients (age 25-44) and 71 percent of older patients (age 65-85) experienced complications as a result of surgery. However, both groups experienced significant improvements in disability, back pain and leg pain. The improvement in these scores was significantly greater among elderly patients than the younger patients.
5. Resection of spinal tumors with Enneking Appropriate margins. A study recently published in Spine found that the surgical resection of spinal tumors with Enneking Appropriate margins can significantly reduce the local recurrence of tumors and mortality. A multicenter ambispective cohort analysis of four tertiary spine care referral centers encompassed 147 patients who were placed in either the Enneking Appropriate or Enneking Inappropriate group. There were 71 patients who suffered at least one local recurrence after an average of four years, and 57 of those patients were in the EI group.
The study also reported 48 deaths, with 29 from the EI group and 19 in the EA group, which the authors suggest shows a strong correlation between the first local recurrence and mortality.
6. Professional athletes report longer careers after surgery. Professional football players with cervical disc herniation have a higher return-to-play rate after operative treatment than those undergoing non-operative treatment. The researchers identified 99 National Football League players who were diagnosed with cervical disc herniation and decided to receive either operative or non-operative treatment. Of those who chose surgical intervention, 72 percent were able to successfully return to play for an average of 29 games over a 2.8-year period. Those in the non-operative group reported returning to play 46 percent of the time for approximately 15 games over a 1.5-year period.
The athlete's age at diagnosis negatively impacted career longevity, and other factors, such as concomitant cervical stenosis, had an impact on the data as well. Researchers published the study in an issue of Spine.
Related Articles on Spine Surgery:
8 Points for Spine Surgeons Treating Professional Athletes
6 Points on Managing the Cost of Spine Care
Study Points to Risk Factors for Cervical Spine Reconstruction Failure
© Copyright ASC COMMUNICATIONS 2011. Interested in LINKING to or REPRINTING this content? View our policies here.