Complications and Risk Factors of Primary Adult Scoliosis Surgery

Charosky, S; Guigui, P.; Blamoutier, A.; Roussouly, Pierre; Chopin, D.

doi:10.1097/brs.0b013e31822ff5c1

Cited by 263 publications

(165 citation statements)

References 23 publications

Supporting

Mentioning

141

Contrasting

Unclassified

Order By: Relevance

“…Radiographic fusion was also achieved in 91%. These results are consistent with other studies on lateral interbody fusion [7][8][9][10][11]. …”

Section: Discussionsupporting

confidence: 83%

The Reliability of Neuromonitoring to Detect Neurologic Injury during Lateral Interbody Fusion

Lee¹,

Gertsch²,

Taylor³

et al. 2015

Spine Res

View full text Add to dashboard Cite

Summary of background data: Lateral interbody fusion is a minimally invasive procedure that is gaining popularity. Hip flexion weakness has been noted postoperatively but the cause of the weakness still remains unknown. The objective of this study is to evaluate if conventional neuromonitoring with electromyography (EMG), somatosensory (SSEP), and motor evoked potentials (MEP) allows surgeons to detect potential nerve injuries that standard EMG monitoring may miss. Method:Patients undergoing lateral interbody fusion were monitored with standard electromyography and conventional neuromonitoring with electromyography, somatosensory evoked potentials, and motor evoke potentials. All consecutive lateral interbody fusion patients who had a minimum 2-year follow-up were included in the analysis. Data gathered included VAS, ODI, as well as radiographic fusion assessment. Hip flexion weakness was considered significant if the muscle grade decreased by 2 or more.Results: 113 subjects were recruited for this study. Pain scores (visual analog scores) decreased from 6.4 ± 2.1 pre-operatively to 3.2 ± 2.35 post-operatively at 2 years (p<0.0001). Functional scores (Oswestry Disability Index) improved by 30% from 41.5 ± 14.6 pre-operatively to 29.2 ± 17.5 post-operatively at 2-year follow-up (p<0.0001). 3 cases of significant hip flexion weakness were noted postoperatively. Electromyography from both systems and somatosensory evoked potenatials from conventional neuromonitoring were unchanged during these cases. Changes were noted on motor evoked potenatials in all three of these cases. This suggests that the hip flexion weakness may be due to a neurologic injury that is occurring during the case despite normal electromyography readings.Discussion: Electromyography is a reliable monitoring tool during lateral intrerbody fusion surgery with a reliability of 97.5% (110/113). However, there is the potential of neurologic injury despite normal electromyograpy and somatorsensory evoked potentials during the case. Physicians need to be aware of this and patients should be counseled appropriately.

show abstract

“…Radiographic fusion was also achieved in 91%. These results are consistent with other studies on lateral interbody fusion [7][8][9][10][11]. …”

Section: Discussionsupporting

confidence: 83%

The Reliability of Neuromonitoring to Detect Neurologic Injury during Lateral Interbody Fusion

Lee¹,

Gertsch²,

Taylor³

et al. 2015

Spine Res

View full text Add to dashboard Cite

show abstract

“…More recently, a retrospective review of data collected from six centres in France (analysing 306 patients) indicated a 39 % overall complication rate for primary adult scoliosis surgery; 26 % of patients were re-operated for mechanical or neurological complications and the risk of re-intervention resulted to be 44 % in the 6-year period after the primary procedure [14].…”

Section: Discussionmentioning

confidence: 99%

Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series

et al. 2013

View full text Add to dashboard Cite

Purpose The surgical approach to adult spine deformities is complex and presents a high incidence of complications. Methods We report here a prospective consecutive case series analysis of 20 patients submitted to posterior correction and instrumented fusion for adult degenerative scoliosis. Clinical outcomes were assessed by self-reported measures. Pre-operative and post-operative complications were analysed during a mean 30-month follow-up period. Results Eleven patients (55 %) presented pre-operative or post-operative complications. Fifteen different complications occurred, six in the early pre-operative period and nine during follow-up period: ten of these complications occurred in patients who underwent a previous surgery for spine disease. Conclusions The clinical improvement at the final follow-up resulted as statistically significant only for the group of patients exposed to posterior fusion without interbody fusion. The observations reported here have to be considered for a shared decision-making in the management of adult scoliosis.

show abstract

“…One study reported a reoperation rate of 7% for isolated decompression, 15% for short fusion and 28% for long fusion in patients with degenerative lumbar scoliosis 2 years after the index surgery [8]. Charosky et al [11] reported a 44% risk of reoperation after a mean follow-up of 5.8 years in patients that had undergone primary adult scoliosis surgery with a mean of seven instrumented levels. Our figures point in the same direction but were without significant differences between the major and minor surgery groups.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, more follow-up data regarding the risk of repeated surgery after several years is needed [8,11,12].…”

Section: Introductionmentioning

confidence: 99%

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Tian

Gerdhem

2017

Eur Spine J

View full text Add to dashboard Cite

Purpose The outcome of surgery for degenerative lumbar scoliosis was studied in the Swedish Spine register. Methods 209 patients (mean age 66 years) were identified; 45 had undergone decompression and/or fusion of one segment (minor group) and 164 had undergone fusion of two or more segments, with or without decompression (major group). Results VAS back pain, VAS leg pain, ODI and EQ-5D index improved after surgery in both groups (p \ 0.05), with medium to large effect sizes of surgery. Global assessment for back pain and satisfaction was significantly better in the major group than in the minor group (p \ 0.05) at the 2-year follow-up. Additional spine surgery was observed in 57 out of the 209 patients during a mean period of 5.4 years. Conclusion Surgery for degenerative lumbar scoliosis improves quality of life with medium to large effect sizes, but carries a high risk of additional surgery.

show abstract

Complications and Risk Factors of Primary Adult Scoliosis Surgery

Cited by 263 publications

References 23 publications

The Reliability of Neuromonitoring to Detect Neurologic Injury during Lateral Interbody Fusion

The Reliability of Neuromonitoring to Detect Neurologic Injury during Lateral Interbody Fusion

Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series

Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Contact Info

Product

Resources

About