Complications in Posterior Fusion and Instrumentation for Degenerative Lumbar Scoliosis

Cho, Gyu-Jung; Suk, Se-Il; Park, Seung-Rim; Kim, Jin-Hyok; Kim, Sung‐Soo; Choi, Won-Kee; Lee, Kang-Yoon; Lee, Seung-Ryol

doi:10.1097/brs.0b013e31814b2d3c

Cited by 319 publications

(212 citation statements)

References 15 publications

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“…First, it has been reported that fusion surgery for DLS has a relatively high complication rate than for other degenerative diseases such as spondylolisthesis [2,4,19]. Therefore, for patients who are poor candidates for massive spinal reconstruction surgery because of their general condition, our decompression technique is a treatment option.…”

Section: Discussionmentioning

confidence: 99%

“…With development in spinal instrumentation, fusion surgery is preferred, especially in patients with degenerative lumbar scoliosis (DLS) due to malalignment and instability. However, fusion surgery poses problems, such as adjacent segment disease and pseudoarthrosis [2,4,19]. Because patients with DLS are often elderly, surgical invasion and instrumentation failure due to osteoporosis also create problems in fusion surgery.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis

et al. 2010

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We performed microscopic lumbar foraminotomy in all the patients diagnosed with degenerative lumbar foraminal stenosis (DLFS) and retrospectively reviewed the clinical outcomes and the factors influencing them. The preoperative Japanese Orthopaedic Association (JOA) score of 13.8 significantly improved to 21.9 postoperatively. Although leg pain reduced in 44 patients (95.7%) immediately after surgery, it recurred in 9 patients (19.6%). The recurrence frequency was significantly higher and the JOA score improvement ratios significantly lower in patients with degenerative lumbar scoliosis (DLS) than in those without DLS. Even among patients with DLS, those with \3°Cobb angle difference between the supine and standing positions showed satisfactory results, with no recurrence. In conclusion, microscopic lumbar foraminotomy for DLFS produced satisfactory clinical outcomes even in patients with DLS. However, the outcomes were poor in patients with unstable DLS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis

et al. 2010

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“…Studies highlighted that complications remain a common occurrence and a significant concern in adult scoliosis surgery, with rates ranging from 10 to 40 % on middle-age adults and higher in the elderly patients. Despite the high complication rates, recent evidence demonstrates the potential benefits of surgical treatment for adult scoliosis, reporting a significant improvement of the outcome measures as compared with baseline measures [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2013

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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.

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“…Several studies have documented the complications of these surgical techniques [1,5,11,23,30]. The reported rates of complications in One of the authors (AAP) owns stock in Amedica (Salt Lake City, UT), Nocimed (Redwood City, CA), and Cytonics (Jupiter, FL); consults for Amedica, Biomet (Warsaw, IN), and Stryker Spine (Kalamazoo, MI); receives royalties from Amedica; and has received research funding from Stryker Spine through his institution.…”

Section: Introductionmentioning

confidence: 99%

“…Anteriorapproach complications include damage to the abdominal organs (\ 1%), vascular injury (1.3%-15.6%), disruption of the sympathetic plexus (1.7%-13.3%), and postoperative ileus (0.6%-5.6%) [6,[29][30][31]. Posterior approaches avoid the aforementioned risks but can lead to soft tissue devitalization, nerve root injuries (9%-16%), postoperative radiculitis (6.7%-16.4%), and incidental durotomies (5.4%-10%) [5,9,26,31]. Newer surgical techniques were developed in hopes of minimizing surgical risks, decreasing in-hospital stay, and potentially improving patient satisfaction [17].…”

Section: Introductionmentioning

confidence: 99%

Complications of the Lateral Transpsoas Approach for Lumbar Interbody Arthrodesis: A Case Series and Literature Review

Sofianos

Briseño

Abrams

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background The lateral transpsoas approach to the lumbar spine was developed to eliminate the need for an anterior-approach surgeon and retraction of the great vessels and has the potential for shorter operative times. However, the reported complications associated with this approach vary. Questions/purposes We identified the incidence of complications associated with the lateral transpsoas approach to the lumbar spine. Patients and Methods We retrospectively reviewed 45 patients who underwent a lateral transpsoas approach to the spine for various diagnoses between January 1, 2006, and October 31, 2010. The patients' average age was 63.3 years. Sixteen (35.6%) patients had prior lumbar spinal surgery.Twenty-one patients (46.7%) underwent supplemental posterior instrumentation. Minimum followup was 0 months (mean, 11 months; range, 0-34 months). Results Eighteen of the 45 patients (40%) had complications: 10 (22.2%) developed postoperative iliopsoas weakness, three had quadriceps weakness, and one experienced foot drop. Eight patients (17.8%) developed anterior thigh hypoesthesia, which did not fully resolve in seven of the eight patients at an average of 9 months' followup. Three patients had postoperative radiculopathies, one a durotomy, and one died postoperatively from a pulmonary embolism. Conclusions We found a 40% incidence of complications and a nontrivial frequency and severity of postoperative weakness, numbness, and radicular pain in patients who underwent a lateral transpsoas approach to the spine. Given the expanding use of the approach, a thorough understanding of the risks associated with it is essential for patient education, medical decision making, and identifying methods of reducing such complications.

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Complications in Posterior Fusion and Instrumentation for Degenerative Lumbar Scoliosis

Abstract: The complication rate after posterior fusion and instrumentation for degenerative lumbar scoliosis was 68%. Abundant blood loss was a significant risk factor for early perioperative complications. The improvement of Oswestry disability index was less in patients with late complications.

Cited by 319 publications

References 15 publications

Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis

Clinical outcomes of microscopic decompression for degenerative lumbar foraminal stenosis: a comparison between patients with and without degenerative lumbar scoliosis

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

Complications of the Lateral Transpsoas Approach for Lumbar Interbody Arthrodesis: A Case Series and Literature Review

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