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  1. #1
    Join Date
    Apr 2009
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    Post Spinal Fusion Statistics

    Our son has been recommended for spinal fusion surgery. To help us get a feel for what that might mean, I've been looking for scholarly papers that provide statistics on fusions. I'd love to know, out of all fusions ever done:
    • patient age
    • patient sex
    • reason for surgery (e.g. idiopathic scoliosis)
    • surgery details (e.g. types of instrumentation)
    • how many had immediate problems, including problem type
    • how many had problems in 1 year, 5 years, 10 years, etc., including problem type
    • how many had no problems

    etc.

    If you aware of any such studies, please post.

    I'd guess this would be a very common question - sorry if it's been asked & answered before. I've looked some through pubmed etc. and I'll continue looking. Hopefully someone else has already gone through this search.

    Summary of our son's situation:
    diagnosed with Chiari malformation, Summer of 2006, age 8
    decompression surgery, Oct 06
    diagnosed with progressing spinal curve, 50 degrees, Fall 2008
    currently not experiencing any symptoms

    Thank You

  2. #2
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    Hi. Welcome.

    I'm not sure the universe of fusion surgeries is going to be AT ALL relevant to your son's situation. I don't even think the non-Chiari fusions (i.e., AIS, Marfan's etc.) in kids are necessarily relevant but what do I know?

    What will be most relevant are surgeries for Chiari done with modern instrumentation at a particular bone age.

    Good luck.
    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."

  3. #3
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    Hi Pooka

    Right, I'm really mostly interested in surgeries closest to my son's situation (11 year old male, Chiari, etc.) but I sort of expect I'd have even less luck finding something that narrowly focused. I'm really surprised I haven't found statistics for a broader set of criteria though...

    Best Wishes

  4. #4
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    I'm guessing there are at least some outcome papers for Chiari in kids of various bone ages but I don't know that.

    I think the best bet is to ask a few surgeons who have done numerous Chiari fusions with modern instrumentation. But maybe they don't specialize at that level (Chiari vice AIS vice Marfans). Then you just need that many more opinions.

    Now that you bring it up, I wonder what percentage of kids' fusions are attributable to AIS vice Chiari vice Marfans vice etc.. I'm guessing the largest group wll be AIS but I don't know that.

    Again, good luck.
    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."

  5. #5
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    PLR i don't want to appear negative because i think the research you're trying to do for your son is great, but i doubt that you'll get the information you want. spinal fusion surgery in its current incarnation is relatively new (i'm not sure where she heard it, it may have been my surgeon who told us, but my mum said that orthopaedics is 20 years behind every other surgical genre in terms of development) - the current instrumentations and techniques have been used widely since the mid 90s and ok that's now over 10 years, but if you consider that most patients are in their teens, those people aren't all that old now! this worried my parents a lot about my surgery: that long term effects aren't really known but you kind of just have to jump off that cliff.

    most people weigh up the benefits of having surgery vs the costs of doing nothing and when you look at it like that, it's a no brainer.

    as i said, i doubt the papers you are looking for exist, though i'm sure they're in development. studies about what patients are like at 1 year post op (and even 2 to 5 years) would be largely useless in my opinion, because some people will only have finished fusing at a year, you wouldn't expect to see a drastic difference between then and the day of the surgery (in terms of it having a negative impact on their life, it would generally only be positive at that point).

    most fusions for AIS are done on girls, JIS is more prevalent in boys and i'm not sure what the stats are for infantile and congenital scoliosis in terms of gender. patient age... well that's a huge variety. some people are diagnosed with AIS but don't have surgery until they are in their 50s for whatever reason.

    sorry i can't be of any more help but like i said, i don't think the research you require in the format you're looking for will be available. however, between the members of this forum there are many experiences available. you will, of course, be able to ask your son's doctor how many surgeries he/she has performed on cases similar to your son's and get an idea from that information.
    diagnosed aged 14 (2001)
    braced from july 2001 to february 2003 to hold curves
    fused T11-L3 on july 16th 2005 (aged 18)
    Discharged by surgeon july 11th 2007 (aged 20 and almost 2 years post-op)
    scoliosis support forum

  6. #6
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291

    Scoliosis fusions have been done for over 40 years.

    I had an old original, uninstrumented fusion in 1956!!!!. It served me well over 40+ years ---and then had a successful revision 6+ years ago. Scoliosis surgery is over 40 years old---but techniques and instrumentation are now far superior.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  7. #7
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    PA
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    PLR,

    Welcome!

    I'm not sure you'll find the studies you are looking for, but have you tried the SpineKids forum? It is similar to this forum, but is visited mostly by kids/teens and a few adults. I know there are several kids on that forum with Chiari malformations and have had surgery. If nothing else, you might find some of the information helpful. Good luck.

    Mary Lou
    Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

  8. #8
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Quote Originally Posted by PLR View Post
    Our son has been recommended for spinal fusion surgery. To help us get a feel for what that might mean, I've been looking for scholarly papers that provide statistics on fusions. I'd love to know, out of all fusions ever done:
    • patient age
    • patient sex
    • reason for surgery (e.g. idiopathic scoliosis)
    • surgery details (e.g. types of instrumentation)
    • how many had immediate problems, including problem type
    • how many had problems in 1 year, 5 years, 10 years, etc., including problem type
    • how many had no problems

    etc.

    If you aware of any such studies, please post.
    PLR, it's highly unlikely that study exists.

    There is a broad study on older instrumentation Linda Racine listed not long ago, but that's as close to what you're seeking as I believe you'll find. There are a few studies out there on AIS fusion surgery, but not really long-term results.

    Spinal fusion hardware and techniques have changed so much over the years, data in a long-term study would become practically irrelevant before compiled. Comparison of fusion surgery results with no instrumentation, fusion surgery with Harrington rods, Luque wires, CD systems, Moss-Miami, ISOLA, TSRH, etc., etc. would be pointless. The different generations of hardware are like apples to oranges, although I know plenty of people with just about all types that have had issues - and those who haven't. Anecdoctal, not science.

    Also, it's rare to see a study list the *exact* type of hardware installed. For that matter, many people *here* don't know what they have inside them.

    The best thing you can do is read these forums for real stories. BTW, you said your son has Chiari, which pretty much disqualifies a patient for inclusion in any broad study - especially mixed with AIS/JIS patients. ACM patients aren't a majority among fusion patients: Most studies that *are* done on fusion are done on AIS/JIS fusion surgery.

    Good luck to y'all.

    Regards,
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

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