Perspective - (2024) Volume 12, Issue 4
Received: 04-Jul-2024, Manuscript No. IPJUS-24-15030; Editor assigned: 09-Jul-2024, Pre QC No. IPJUS-24-15030 (PQ); Reviewed: 23-Jul-2024, QC No. IPJUS-24-15030; Revised: 01-Aug-2024, Manuscript No. IPJUS-24-15030 (R); Published: 29-Aug-2024
Scoliosis is a medical condition characterized by an abnormal lateral curvature of the spine. While it can affect individuals of all ages, it is commonly diagnosed in children and adolescents. Early intervention is often recommended to manage the condition and prevent its progression. However, some individuals may not receive or opt for treatment until adulthood. Undergoing scoliosis surgery at a later stage presents several disadvantages, ranging from increased surgical risks to prolonged recovery periods and potential complications.
Increased surgical risks
Greater curve magnitude: One of the primary challenges of delaying scoliosis surgery is the increased curvature of the spine. Over time, scoliosis can progress, leading to more severe deformities. A larger curve magnitude not only complicates the surgical procedure but also increases the likelihood of complications. Surgeons must work with more complex spinal structures, which can result in longer operative times and higher risks of intraoperative blood loss and neurological injury.
Degenerative changes: As individuals age, the spine undergoes natural degenerative changes, including disc degeneration, osteoarthritis, and bone spurs. These changes can complicate scoliosis surgery, making it more difficult to achieve optimal spinal alignment and stability. Additionally, degenerative changes can increase the risk of postoperative complications, such as infection, non-union of the surgical fusion and adjacent segment disease, where degeneration occurs in the spinal segments adjacent to the fused area.
Comorbidities: Older adults are more likely to have comorbid medical conditions, such as cardiovascular disease, diabetes, and osteoporosis. These conditions can increase the risks associated with scoliosis surgery. For example, cardiovascular disease can complicate anesthesia management, while osteoporosis can weaken the bones, making it more challenging to achieve and maintain spinal fusion. The presence of comorbidities also increases the likelihood of postoperative complications, such as infections, delayed healing, and prolonged hospital stays.
Prolonged recovery period
Slower healing: The body's ability to heal and recover diminishes with age. Older adults typically experience slower wound healing and tissue regeneration compared to younger individuals. This can result in prolonged recovery periods following scoliosis surgery. Delayed healing can also increase the risk of postoperative complications, such as infections, wound dehiscence (reopening of the surgical wound), and non-union of the spinal fusion.
Reduced physical resilience: Older adults often have reduced physical resilience and lower levels of physical fitness compared to younger individuals. This can make it more challenging to engage in postoperative rehabilitation and physical therapy, which are crucial for a successful recovery. Limited mobility and physical strength can also hinder the ability to perform daily activities and maintain independence during the recovery period.
Increased pain and discomfort: Postoperative pain and discomfort are common following scoliosis surgery, but they can be more pronounced and prolonged in older adults. Age-related changes in the nervous system, such as decreased pain tolerance and increased sensitivity to pain, can exacerbate postoperative discomfort. Additionally, older adults may be more susceptible to chronic pain conditions, which can further complicate the recovery process.
Potential complications
Neurological complications: Scoliosis surgery carries the risk of neurological complications, such as nerve damage and spinal cord injury. The likelihood of these complications increases with age due to the more complex spinal anatomy and degenerative changes. Neurological complications can result in long-term or permanent deficits, including numbness, weakness, and loss of bladder or bowel control. These complications can significantly impact the quality of life and functional independence of older adults.
Pulmonary complications: Older adults are at higher risk of pulmonary complications following scoliosis surgery. Age-related changes in lung function, such as decreased lung capacity and diminished respiratory muscle strength, can impair the ability to clear secretions and maintain adequate ventilation.
This increases the risk of postoperative pneumonia, atelectasis (collapse of part of the lung), and respiratory failure. Pulmonary complications can prolong hospital stays and recovery periods, as well as increase the risk of mortality.
Cardiovascular complications: Scoliosis surgery in older adults carries an increased risk of cardiovascular complications. The stress of surgery and anesthesia can exacerbate pre-existing cardiovascular conditions, such as hypertension, coronary artery disease, and heart failure. Potential complications include myocardial infarction (heart attack), arrhythmias (irregular heartbeats), and thromboembolic events (blood clots). Cardiovascular complications can be life-threatening and require intensive medical management.
While scoliosis surgery can provide significant benefits, such as pain relief and improved spinal alignment, delaying surgery until a later stage presents several disadvantages. Increased surgical risks, prolonged recovery periods, potential complications, psychosocial impact, and financial considerations are important factors to consider when making treatment decisions. Early intervention and proactive management of scoliosis can help mitigate these challenges and improve overall outcomes. For individuals who require scoliosis surgery at a later stage, comprehensive preoperative assessment, meticulous surgical planning, and multidisciplinary care are essential to optimize results and enhance quality of life.
Citation: Stefrad S (2024) Disadvantages of Getting Scoliosis Surgery at a Later Stage. J Univ Surg Vol.12 No.4: 037.
