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Thread: % of people who are happy after surgery

  1. #1
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    % of people who are happy after surgery

    I was wondering; what do you think is the percentage of people who are happy with the outcome of their surgery opposed to those that wish they hadn't had it done.

    My surgeon said that 2/3rd of patients are satisfied after surgery but reading this board - it seems many more people are happy than not.

    My thinking at the moment is that it is not a high risk that it will not be successful BUT if it is not successful it can be devestating?

  2. #2
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    Quote Originally Posted by fandango View Post
    I was wondering; what do you think is the percentage of people who are happy with the outcome of their surgery opposed to those that wish they hadn't had it done.

    My surgeon said that 2/3rd of patients are satisfied after surgery but reading this board - it seems many more people are happy than not.

    My thinking at the moment is that it is not a high risk that it will not be successful BUT if it is not successful it can be devestating?
    I can only speak for myself, but I am very happy, and thankful that I had such good results. I know it's not like that for everyone.
    __________________________________________
    Debbe - 50 yrs old

    Milwalkee Brace 1976 - 79
    Told by Dr. my curve would never progress

    Surgery 10/15/08 in NYC by Dr. Michael Neuwirth
    Pre-Surgury Thorasic: 66 degrees
    Pre-Surgery Lumbar: 66 degrees

    Post-Surgery Thorasic: 34 degrees
    Post-Surgery Lumbar: 22 degrees

  3. #3
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    I'm extremely happy with my results. My spine surgeon couldn't really guarantee that the nerve pain down the leg would go completely, but the Neuro said that he thought that, after having the scoli correction he would be very surprised if the pain didn't go away completely or at least 99.9%. I had to take that chance and i'm glad i did!
    Vali
    44 years young! now 45
    Surgery - June 1st, 2009
    Dr David Hall - Adelaide Spine Clinic
    St. Andrews Hospital, Adelaide, South Australia
    Pre-op curve - 58 degree lumbar
    Post -op - 5 degrees
    T11 - S1 Posterior
    L4/5 - L5/S1 Anterior Fusion

  4. #4
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    Fandango, I have wondered the same thing. It seems that on this forum most people are happy with the outcome. Recently someone posted who regretted have surgery, but that is the only one I've seen. I am going into this as a preventive measure since I have no pain so it is really an issue for me. I am closing my eyes and taking the leap. I'm wondering what the impression is of those people who had surgery years ago, or of the moderators who have heard it all.

  5. #5
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    I think that the satisfaction rate we see at UCSF is really high. It wouldn't surprise me to find that <5% of patients are unhappy with their result. Unfortunately, if you're in that 5%, it doesn't make any difference that 95% of people had a great outcome.

    What you probably really want to know is what percent of the patients who had surgery similar to what you're having, and which was performed by your surgeon, are happy. There's no way to verify that unfortunately. The best you can do is to talk to as many people as you can find who have had surgery performed by your surgeon.
    Here's a review of scoliosis surgery outcome papers:

    Adult scoliosis surgery outcomes: a systematic review.

    Yadla S, Maltenfort MG, Ratliff JK, Harrop JS.

    Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. sanjay.yadla@jeffersonhospital.org
    Abstract

    OBJECT: Appreciation of the optimal management of skeletally mature patients with spinal deformities requires understanding of the natural history of the disease relative to expected outcomes of surgical intervention. Appropriate outcome measures are necessary to define the surgical treatment. Unfortunately, the literature lacks prospective randomized data. The majority of published series report outcomes of a particular surgical approach, procedure, or surgeon. The purpose of the current study was to systematically review the present spine deformity literature and assess the available data on clinical and radiographic outcome measurements. METHODS: A systematic review of MEDLINE and PubMed databases was performed to identify articles published from 1950 to the present using the following key words: "adult scoliosis surgery," "adult spine deformity surgery," "outcomes," and "complications." Exclusion criteria included follow-up shorter than 2 years and mean patient age younger than 18 years. Data on major curve (coronal scoliosis or lumbar lordosis Cobb angle as reported), major curve correction, Oswestry Disability Index (ODI) scores, Scoliosis Research Society (SRS) instrument scores, complications, and pseudarthroses were recorded. RESULTS: Forty-nine articles were obtained and included in this review; 3299 patient data points were analyzed. The mean age was 47.7 years, and the mean follow-up period was 3.6 years. The average major curve correction was 26.6 degrees (for 2188 patients); for 2129 patients, it was possible to calculate average curve reduction as a percentage (40.7%). The mean total ODI was 41.2 (for 1289 patients), and the mean postoperative reduction in ODI was 15.7 (for 911 patients). The mean SRS-30 equivalent score was 97.1 (for 1700 patients) with a mean postoperative decrease of 23.1 (for 999 patients). There were 897 reported complications for 2175 patients (41.2%) and 319 pseudarthroses for 2469 patients (12.9%). CONCLUSIONS: Surgery for adult scoliosis is associated with improvement in radiographic and clinical outcomes at a minimum 2-year follow-up. Perioperative morbidity includes an approximately 13% risk of pseudarthrosis and a greater than 40% incidence of perioperative adverse events. Incidence of perioperative complications is substantial and must be considered when deciding optimal disease management. Although the quality of published studies in this area has improved, particularly in the last few years, the current review highlights the lack of routine use of standardized outcomes measures and assessment in the adult scoliosis literature.

  6. #6
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    Linda, 41% of adult patients had complications according to the article. That seems very high. What are your thoughts?

  7. #7
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    Hi Joy...

    The 41% seems about right. (The study excluded patients below 18.) Complications can range from a dural tear to death. The vast majority of the complications are not long lasting or life threatening. When I talk to people who had a complication like an infection, they're not overly happy while they're going through the treatment, but afterward they report that it was no big deal. As you can see from the referenced abstract, the complications don't impact satisfaction.

    Regards,
    Linda

  8. #8
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    Quote Originally Posted by LindaRacine View Post
    Hi Joy...

    The 41% seems about right. (The study excluded patients below 18.) Complications can range from a dural tear to death. The vast majority of the complications are not long lasting or life threatening. When I talk to people who had a complication like an infection, they're not overly happy while they're going through the treatment, but afterward they report that it was no big deal. As you can see from the referenced abstract, the complications don't impact satisfaction.

    Regards,
    Linda
    Also it seems like the Harrington rod patients were included. If they broke out H rod versus pedicle screw I bet the numbers would group into two fairly distinct ranges.

    In fact I would not be surprised if the two groups were:

    1. H rod for lumbar (low satisfaction)

    2. everyone else (H rod for T curves and pedicle screws for all curves) (high satisfaction)
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #9
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    Hi Linda
    hmmmm....follow up shorter than 2 years...?? so if the "complication" is corrected...either from time or some kind of treatment...assume that they are eliminating those needing revision surgery...? then what??...i kinda thought they should follow up after 1 year, after 2 and after 4...
    of course, i gotta hope when i finally have the surgery, MY complication isnt death


    jess

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    Quote Originally Posted by jrnyc View Post
    Hi Linda
    hmmmm....follow up shorter than 2 years...?? so if the "complication" is corrected...either from time or some kind of treatment...assume that they are eliminating those needing revision surgery...? then what??...i kinda thought they should follow up after 1 year, after 2 and after 4...
    of course, i gotta hope when i finally have the surgery, MY complication isnt death


    jess
    Hi Jess...

    The "less than 2 years" was a noted exclusion. That is, only papers that had at least 2 years of follow up were included.

    The gold standard for scoliosis surgery outcomes is arguably the papers that have been coming out of the Spinal Deformity Study Group. Those studies will eventually have 20 year follow up.

  11. #11
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    ummm..thanks, Linda...my fault for speed reading a medical study..not what that kinda reading was made for...my apologies...

    i reread the study.....interesting....i hope others dont pick up the 41% statistic and get discouraged...i guess the kind and degree of complication is the concern...Dr Lonner told me that after he operates ("fixes" me, i tell my puppy) later on i might need screws or other hardware removed...i am thin and there is a chance stuff could poke thru or somethin'.....
    am assuming that would be considered a "complication," but it would be fixable...so how do studies account for successful revisions of complications?

    jess

  12. #12
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    It makes me wonder if the nature of the forum itself isn't creating a biases toward the "good" outcomes. Those having good outcomes would want to encourage others not to be afraid of the surgery, because, after all, it helped the person with the good outcome.

    Biases are very difficult to get away from. And other than a parent reporting a child's death, which unfortunately I have seen here, I doubt very highly that family members of the deceased will be in too much of a hurry get on this board and report the outcomes. They will be dealing with grief, etc...

    Research papers and studies are the best way to find out real results, as Linda suggested.

  13. #13
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    Quote Originally Posted by jrnyc View Post
    ummm..thanks, Linda...my fault for speed reading a medical study..not what that kinda reading was made for...my apologies...

    i reread the study.....interesting....i hope others dont pick up the 41% statistic and get discouraged...i guess the kind and degree of complication is the concern...Dr Lonner told me that after he operates ("fixes" me, i tell my puppy) later on i might need screws or other hardware removed...i am thin and there is a chance stuff could poke thru or somethin'.....
    am assuming that would be considered a "complication," but it would be fixable...so how do studies account for successful revisions of complications?

    jess
    My doctor told me I am committing myself to two surgeries because I am thin, too. He said the hardware will likely bother me and restrict range of motion in my arms. But that's a chance I'm willing to take if I feel better after the second surgery!

  14. #14
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    Quote Originally Posted by jrnyc View Post
    .so how do studies account for successful revisions of complications?

    jess
    Hi Jess...

    Sorry, but I don't understand the question.

  15. #15
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    Quote Originally Posted by rohrer01 View Post
    It makes me wonder if the nature of the forum itself isn't creating a biases toward the "good" outcomes. Those having good outcomes would want to encourage others not to be afraid of the surgery, because, after all, it helped the person with the good outcome.

    Biases are very difficult to get away from. And other than a parent reporting a child's death, which unfortunately I have seen here, I doubt very highly that family members of the deceased will be in too much of a hurry get on this board and report the outcomes. They will be dealing with grief, etc...

    Research papers and studies are the best way to find out real results, as Linda suggested.
    Actually, it used to be entirely the opposite. The people who sought out the internet were those with bad outcomes, trying to find others like themselves or resources.

    As it is, if you look at some of the earliest posts on these forums, most of the people who have had surgery have gone on with their lives, and no longer post.

    It's interesting to me that the vast majority of the patients that I've talked to in my job have not sought out information on the internet, and know nothing of these forums.

    --Linda

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