View Full Version : Delaying Surgery

02-16-2007, 10:34 AM

Older Patients Shouldn't Delay Spinal Surgery: Study
02.16.07, 12:00 AM ET

FRIDAY, Feb. 16 (HealthDay News) -- Delaying having spinal reconstruction surgery to correct spinal deformities such as scoliosis may increase the risk of surgical complications, U.S. researchers say.

Their study found that patients over the age of 69 are about nine times more likely to suffer complications.

"The study shows that waiting too long to have major reconstructive spine surgery can dramatically increase the risk of complications," Dr. Lawrence G. Lenke, an orthopedic spine surgeon and a professor of orthopedic surgery at the Washington University School of Medicine in St. Louis, said in a prepared statement.

"In fact, sometimes waiting too long means the disease state has progressed to a point that would make any kind of surgical solution unsafe," Lenke said.

Researchers evaluated the effect that patient age had on complications and outcomes for major spinal deformity surgeries. They concluded that patients over age 60 have an overall complication rate of 37 percent and a major complication rate of 20 percent.

"We found the major risks associated with complex, multi-level spinal reconstruction in patients 60 to 69 years of age were similar to that of lesser surgeries performed on patients in the same age group," Dr. Michael D. Daubs, an orthopedic spine surgeon and an assistant professor of orthopedic surgery at the University of Utah, said in a prepared statement.

"But after age 69, the risks jump significantly for those having complex procedures, including trunk imbalance correction," Daubs said.

The patients included in this study had suffered spinal deformity-related pain for years and had tried all non-surgical options to manage their pain. Surgery was their last hope.

"The study also shows that patients age 60 and older can benefit from major reconstructive spinal surgery. Patients in our study showed significant functional improvement at the two-year follow-up," Daubs said.

He noted that people with spinal deformities often experience painful degenerative spinal changes in their 40s and 50s, but many of them delay having surgery.

The study was scheduled to be presented on Friday at the American Academy of Orthopaedic Surgeons annual meeting, in San Diego.

02-16-2007, 03:18 PM
Thanks Linda ... more evidence in support of my decision :)

02-16-2007, 04:11 PM
"In fact, sometimes waiting too long means the disease state has progressed to a point that would make any kind of surgical solution unsafe," Lenke said.

Such as paralysis, which I've already been told I'm at higher risk for?


Karen Ocker
02-18-2007, 07:39 PM
People in those age groups have more "co-morbidities". This means they have other co-existing diseases such as diabetes, heart disease, obesity etc.

I haven't seen anything suggesting paralysis is higher in that group.
In 1956, when I had my first scoliosis operations with a 100 deg thoracic curve my risk for paralysis was high. Now they use evoked potential monitoring which monitors the spinal nerves during surgery. There are special technicians who do this. They also do the "wake-up test" where you must move your legs before they close the incision to ensure no paralysis. This was done on me but I do not remember it at all. I read it in my operative report.

By the way all sorts of people thow the word "paralysis"--a very rare event-- around when talking about scoliosis operations as a scare tactic.

02-19-2007, 09:26 AM
By the way all sorts of people throw the word "paralysis"--a very rare event-- around when talking about scoliosis operations as a scare tactic.

Now I'm really confused!!! Are you suggesting then that the surgeon who told me I'm at higher than average risk for paralysis was using that as a scare tactic to frighten me away? If so, he certainly succeeded. He also added that each of the surgeons I have consulted with has had patients who were paralyzed.


Karen Ocker
02-19-2007, 06:42 PM
Chris that might be so in your case but the doctor must tell you this. Is was so in my case also because I was a revision, had 3 large curves, and was 60. As I wrote in the other post, all precautions are taken to avoid it: spinal cord monitoring and wake-up test.

I asked myself if I could go on like this(progressing curves/lung impairment) and I made the decision to go ahead with the surgery. Each person must bite the bullet, make decisions and live with the outcomes. There are no guarantees but the studies show good outcomes with complex cases even in older patients-like me.
Basically, it is a lonely decision despite all the support in the world.

02-21-2007, 02:42 AM
This may be way out in left field, but I have never considered myself as having a disease. I have always considered it as a condition. Am I wrong???

I remember being told as a teen that after I reached a certain age that nothing could be done for me. Also that progression was unlikely, and it's so apparent among those of us here on this forum, that our prognosis was not correct!!!

I am so thankful that some medical professionals have dedecated their time and skills to help us!!! I only hope that they are aware of this forum, and how much good it has done for so many of us!!! And how much we appreicate their efforts!!!

My wish is that the Doctor's performing this surgery, will find a way to unite their ideas and efforts, obviously understanding that we may all have scoloisis, and knowing we are all still different!!! I think it's a complicated situation, but I think it will be resolved!!!

It's rough, but it's worth it!!!


02-22-2007, 09:53 AM
“Any condition that impairs the normal functioning of an organism can be called a disease.”

Shari, I always thought of scoliosis as a condition as well until I read Michael Neuwirth’s “The Scoliosis Sourcebook” and he kept referring to it as a disease. I now consider myself to be in poor health rather than good health knowing I have this progressive disease and especially since my scoliosis is severe.


02-22-2007, 10:57 AM
Hmmmm. I DO consider myself in good health, with an infrastructure problem. As opposed to something systemic, like cancer. I compare it to needing a hip or knee replacement: a hardware problem that's mostly fixable.