Radiographic Implications of the Surgical Waiting List for the Treatment of Spinal Deformity

Abstract

Objective: The aim of this study was to evaluate the implications of long waiting times on surgery lists for the treatment of patients with scoliosis. Methods: Radiographs of 87 patients with scoliosis who had been on the waiting list for surgery for more than six months were selected. Two surgeons answered questionnaires analyzing the radiographs when entering the waiting list and the current images of each patient. Results: Data from 87 patients were analyzed. The mean waiting time for surgery was 21.7 months (ranging from seven to 32 months). The average progression of the Cobb angle in the curvature was 21.1 degrees. Delayed surgery implied changes in surgical planning, such as greater need of instrumentation, osteotomies, and double approach. Conclusions: Long waiting lists have a significant negative impact on surgical morbidity of patients with scoliosis, since they increase the complexity of the surgery.

Characterization of environmental factors in children and adolescents with cerebral palsy in Minas Gerais: Participa Minas

“…However, in practice, the approval of such procedures tends to be slow and bureaucratic, which can make it difficult to perform them in the appropriate timeframe, or even lead to a decline in functioning. 22 …”

Necessidades não atendidas de cuidados cirúrgicos para crianças: Estudo de caso no Sistema Único de Saúde financiado pelo governo no Brasil

“…The SUS was created after the 1988 Brazilian Constitution recognized health as a citizen's right and duty of the state. 15 16 Problems related to waiting times for the treatment of spinal deformities have been reported in Brazil 3 13 14 and in other countries like Canada, the United Kingdom, 10 and New Zeland. 8 The average waiting time was of 1 year in Canada, 4 7 12 of 5 to 9 months in the United Kingdom (according to Clark 10 ), and of 2.5 weeks to 2.9 years in New Zeland.…”

“…O SUS foi criado após a Constituição brasileira de 1988 reconhecer a saúde como direito e dever do Estado. 15 16 Problemas relacionados ao tempo de espera para o tratamento de deformidades da coluna vertebral foram relatados no Brasil 3 13 14 e em outros países como Canadá, Reino Unido, 10 e Nova Zelândia. 8 O tempo médio de espera foi de 1 ano no Canadá, 4 7 12 de 5 a 9 meses no Reino Unido (segundo Clark 10 ), e de 2,5 semanas a 2,9 anos na Nova Zelândia.…”

“…10,11 A few studies have shown the impact of long waiting times for the surgical treatment of scoliosis in Canada 4,7,12 and in Brazil. 3,13,14 Despite improvements in primary health care, the SUS has faced challenges in delivering universal and equitable health care to 209 million Brazilians. 15 Allocation decisions and planning occur at National Health Conferences, which are held every four years in accordance with a federal law.…”

“… 10 11 A few studies have shown the impact of long waiting times for the surgical treatment of scoliosis in Canada 4 7 12 and in Brazil. 3 13 14 …”