Review Article: Approach-Related Complications of Open versus Thoracoscopic Anterior Exposures of the Thoracic Spine

Cheung, Kenneth M.C.; Ghazi, S

doi:10.1177/230949900801600315

Cited by 18 publications

(11 citation statements)

References 19 publications

(75 reference statements)

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“…In the postoperative complications, 10%-30% incidence of the cardiac, vascular, gastrointestinal and technical complications were reported by Cheung and Al Ghazi [2]. However, we did not encounter cardiac complications.…”

Section: Discussionmentioning

confidence: 43%

“…Acute respiratory difficulty due to cervical hematoma compressing the trachea and/or cervical cord above C 4 and due to the slipped graft bone should be managed urgently [2,4,5]. …”

Section: Discussionmentioning

confidence: 99%

“…Cheung and Al Ghazi [2] strongly advised that when the T 4 -T 9 bodies are approached, segmental arteries should be divided close to their origins to enable collateral circulation through the internal mammary and intercostal arteries to minimize the cord infarction. However, unilateral division of segmental arteries at their origin rarely resulted in cord ischemia [2]. The more the levels of ligation, higher were the risk of spinal cord ischemic damage; and bilateral ligation in case of the total spondylectomy was at a higher risk than the unilateral ligation.…”

Section: Discussionmentioning

confidence: 99%

“…Also paralysis secondary to cord stretch ischemia could occur during instrument-aided distractive correction of severe thoracic spinal deformities, though the incidence was reported to be less than 1% [2]. We did not encounter paralysis by cord stretch ischemia by adjusting the cord and canal length equal during correction, though the cord was directly injured during corrective osteotomy in two [13].…”

Section: Discussionmentioning

confidence: 99%

“…The studies deal largely with the methods and results of the management [1,2,3,4,5,6,7,8,9,10]: the surgical management of the different lesions and reconstruction of the surgical defect; and deformity correction and stabilization [11,12,13,14,15,16,17]. There were studies on the overall healing and fusion rates, residual kyphosis [7], bone graft complications, surgical method of reconstruction, deformity correction methodology and its effectiveness [7,10,18,19,20,21,22,23,24], instrument-aided posterior versus anterior surgical deformity correction and stabilization for maintenance of the corrected curve and neurological change [10,11,12,13,14,16,24].…”

Section: Introductionmentioning

confidence: 99%

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Surgery-Related Complications and Sequelae in Management of Tuberculosis of Spine

et al. 2014

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Study DesignMedical record-based survey.PurposeTo survey the overall incidence of the intra- and postoperative complications and sequelae, and to propose the preventive measures to reduce complications in the spinal tuberculosis surgery.Overview of LiteratureThere is no study focused on the surgery-related complications and sequelae, with some touching lightly on the clinical problems.MethodsThere were 901 patients in this study, including 92 paraplegics. One hundred eighty-six patients had no visible deformity, while those of 715 patients were visible. Six hundred fifty-nine patients had slight to moderate non-rigid kyphosis, and 56 had severe rigid kyphosis. Sixty-seven out of 92 paraplegics had slight to moderate non-rigid kyphosis, and 25 had severe kyphosis. There were 134 cervical and cervicodorsal lesions, 518 thoracic and thoracolumbar lesions, and 249 lumbar and lumbosacral lesions. Seven hundred sixty-four patients had primarily anterior surgeries, and 137 had posterior surgeries. Instrumentation surgery was combined in 174 patients.ResultsThere were intra- and postoperative complications: direct large vessel and neurological injuries (cord, roots, nerves), late thrombophlebitis, various thoracic cavity problems, esophagus and ureter injuries, peritoneum perforation, ileus, wound infections, stabilization failure, increase of deformity and late adjacent joint and bone problems. Thrombophlebitis and sympatheticolysis symptoms and signs in the lower limbs were the most common complications related with anterior lumbar and lumbosacral surgeries. Kyphosis increased in 31.5% of the non-instrumented anterior surgery cases (42% in children and 21% in adults).ConclusionsThe safe, effective and most familiar surgical procedure should be adopted to minimize complications and sequelae. Cosmetic spinal surgery should be withheld if functional improvement could not be expected.

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Section: Discussionmentioning

confidence: 43%

“…Acute respiratory difficulty due to cervical hematoma compressing the trachea and/or cervical cord above C 4 and due to the slipped graft bone should be managed urgently [2,4,5]. …”

Section: Discussionmentioning

confidence: 99%