First published August 13, Two common questions frequently arise when someone first learns about scoliosis and the available treatment options : Can scoliosis kill you; and can scoliosis surgery kill you? While scoliosis itself cannot kill you by itself some types of scoliosis also have additional health issues , scoliosis surgery can have significant risks including infection and death.
As we mentioned briefly above, scoliosis alone cannot kill you. This may cause a reasonable bias in publications on this topic. A case report is of limited evidence. In conclusion, the surgery practice for EOS is not supported by a high-quality research.
In the absence of symptoms, some patients do not want surgery. Severe cases, as reported in literature, now have the potential to be managed with high-quality conservative treatment rather than immediate surgery. The company is held by the spouse of HR Weiss. HRW drafted and conducted the research.
The first draft was copyedited in English by Kathryn Moramarco. The author would like to thank Editage www. A written informed consent was obtained from the patient to publish his data, clinical pictures, and radiographs within scientific articles.
National Center for Biotechnology Information , U. J Phys Ther Sci. Published online Dec Hans-Rudolf Weiss , MD 1. Author information Article notes Copyright and License information Disclaimer. Corresponding author. E-mail: moc. Received Jul 4; Accepted Aug Keywords: Early onset scoliosis, Endurance sports, Physical rehabilitation. Open in a separate window. Acknowledgments HRW drafted and conducted the research. Scoliosis , , 1 : 2. JAMA , , : — Stud Health Technol Inform , , 91 : 68— A study of mortality, causes of death, and symptoms.
This death resulted from radiographically confirmed pneumonia 4 years and 10 months after spinal deformity surgery using pedicle screws. Anteroposterior spinal deformity correction with hybrid instrumentation provided excellent and stable correction at the 2-year follow-up. There were no statistically significant differences of coronal balance or pelvic obliquity pre- and postoperatively between the study groups Table 2. There was no radiographic evidence of a nonunion at follow-up. The mean age at operation was There were five boys in the hybrid group and six boys in the pedicle screw group.
The mean implant density per fused vertebral bodies was significantly higher in the pedicle screw group than in the hybrid group 2. There tended to be more fused segments in the pedicle screw group All ambulatory patients maintained their walking ability. The complications in the hybrid group were: one pneumothorax due to central venous access treated with pleural drainage, one prolonged pneumonia needing intensive care and ventilator treatment, one superior mesenterial artery syndrome necessitating total parenteral nutrition, one implant failure, one urinary retention and urosepsis, one chylothorax, and one spinal cord deficit the latter two in same patient.
The complications in the pedicle screw group were: one dural lesion, one transient loss of MEPs, one implant failure, one pleural effusion, and one positive sagittal balance due to lumbosacral junctional kyphosis causing walking difficulties after instrumentation to L5. An L3 pedicle subtraction osteotomy and pelvic fixation was performed, which solved this issue.
One patient experienced transient loss of MEPs during scoliosis surgery due to a high thoracic pedicle screw inserted into the spinal canal. After screw removal, MEPs returned and the patient recovered uneventfully without any neural deficits.
There was one paraparesis in the hybrid group necessitating urgent re-decompression of the anterior spinal cord due to compression of the bone graft applied anteriorly after VCR with full recovery.
The implant failures included one rod breakage just above the iliac connector and one iliac connector breakage. Altogether, one patient in both groups required revision surgery. In a subgroup analysis, patients with nonneuromuscular scoliosis were excluded. Correction of the major curve was significantly better at 6 months mean 60 vs.
The operative time tended to be shorter in the pedicle screw group than in the hybrid group mean 7 h 40 min vs. The current study represents a comparative clinically based follow-up study in a consecutive series of patient groups undergoing surgery for severe scoliosis with either hybrid or total PSI.
The data presented have been collected via a prospective systematic data collection system, although the study design was retrospective in nature. Selection between hybrid and total PSI, as well as between anteroposterior versus posterior-only surgery represents more development in the current surgical techniques, with a tendency to perform as much surgery via the posterior-only approach due to the pulmonary complications.
Since the findings of this study represent a single-surgeon series, it is possible that the results somewhat reflect the learning curve of the senior surgeon during the study period.
The etiology of scoliosis was mixed in this population. The higher implant density may be one of the explaining factors for enhanced deformity correction in the pedicle screw group as compared with the hybrid group. Pedicle screw patients had bilateral segmental fixation and also more Ponte osteotomies and pelvic fixations than the hybrid group. On the other hand, significantly more anterior discectomies were performed in the hybrid group to facilitate spinal deformity correction.
These factors may also have influenced the better correction, less operative time, less blood loss, and more posterior surgery in the pedicle screw group compared to the hybrid group.
The position of the pedicle screws was not routinely checked with computed tomography CT scans. Thus, only complications caused by the malposition of pedicle screws can be reported in the present study. The question of when to include pelvic fixation in the correction of neuromuscular scoliosis remains somewhat controversial.
More patients received pelvic fixation in the pedicle screw group as compared with the hybrid group. No patient was lost during the minimum 2-year follow-up. Recently, there have been reports of better radiographic outcomes using PSI for adolescent idiopathic scoliosis as compared to hybrid constructs [ 3 , 5 , 6 , 15 ]. Similar comparative studies in patients with severe scoliosis are lacking.
Watanabe et al. However, in their series, one-third of patients operated using pedicle screws had a VCR procedure, which obviously makes the comparison less reliable.
In the present study, a similar number of patients in both groups underwent VCR, but, still, the correction of the deformities was better using PSI.
Most of our patients had a neuromuscular scoliosis. In these patients, correction of the spinal deformity is less important than for patients with adolescent idiopathic scoliosis and, thus, the higher radiographic correction of the deformity when using pedicle screws is a positive finding, but may not be the most clinically relevant finding. On the other hand, correction of the severe neuromuscular scoliosis to allow for better seating, feeding, etc.
All posterior instrumentation using bilateral pedicle screws provided excellent correction and no loss of correction during the 2-year follow-up. Kuklo et al. Three patients had an anteroposterior approach. Hamzaoglu et al. Koller et al. One-third of 45 patients in this study underwent open anterior release, but none had VCR.
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. Adult scoliosis has a death rate of 2. 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 addition, depending upon the type of treatment a person chooses, this can come with additional risks and complications, such as with spinal-fusion surgery. While any surgery comes with risks, spinal fusion is a particularly lengthy and invasive procedure. 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.
There is also a big gap in the research documenting long-term effects of spinal fusion; this is why I favor a functional approach that achieves a structural change safely and with few, if any, side effects. Can Scoliosis Kill You?
Can Someone Die From Scoliosis? Leaving Scoliosis Untreated in Adults As mentioned, two big differences between idiopathic adolescent scoliosis and adult idiopathic scoliosis is progression and pain.
Extreme Forms of Scoliosis With addressing the question of whether or not scoliosis can cause death, I feel there is also an interest in extreme forms of scoliosis: the ones a person would likely assume to have the worst potential consequences.
Can Scoliosis Surgery Kill You?
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