An article published in the June 2012 Scoliosis followed 40 patients with Adolescent Idiopathic scoliosis (AIS) who underwent surgical fusion with rods and hooks. Surprisingly, researchers only found a post-operative improvement of less than 50%. A further surprise, after a 5 year follow-up the average loss of correction was almost another 10% suggesting the initial 50% reduction was decreased to under 40%. Most patients are under the impression that scoliosis surgery will eliminate the curve.
Shockingly, the researchers determined that within the first 30 days, 3 out of the 40 patients (7.5%) received a second surgery to correct dislocated hooks and rods.
After 4 years, an unbelievable 19 out of the 40 studied (47.5%; including 2 patients who had a second surgery just a month after their first) had received surgery again. 10 of these patients (25%) experienced late infection, 7 developed fistulae (abscess that connects to the body surface) and 3 cases experienced putrid secretions.
Overall, complete implant removal was necessary for 8 out of the 40 patients (20%) for late operate site pain (LOSP).
The authors concluded:
“Retrospectively, we documented for the first time a very high revisions rate in the patients with AIS and treated with instrumentation. Nearly, half of the instrumentation had to be removed due to late infection and LOSP.”
Another study, published in 2013, expanded on this study of ‘modern’ double rod instrumentation. The authors discussed the risks and long-term complications of AIS surgery versus non-surgical and natural history outcomes and concluded:
“A medical indication for AIS spinal fusion surgery does not exist, except in extreme cases. The rate of complications of spinal fusion surgery appears to increase with time. The risk/reward relationship of spinal fusion surgery is unfavourable for the AIS patient, except in rare cases. There is no evidence that spinal fusion surgery improves quality of life for AIS patients versus natural history. The risks and long-term costs, in terms of pain and suffering, after spinal fusion surgery exceeds what is reasonable for AIS patients, putting the common practice of surgery in question, except in extreme cases.” (Weiss, 2013)