Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

Modi, Hitesh N.; Suh, Seung Woo; Yang, Jae Hyuk; Cho, Jae-Woo; Hong, Jae Young; Singh, Surya; Jain, Saksham

doi:10.1186/1748-7161-4-11

Cited by 67 publications

(46 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The previous reports showed also that most of the major complications were respiratory. 10,15 In the present study, the Cobb angle tended to be higher in the group with major complications than the group without major complications, although this tendency was not statistically significant. Kang et al reported patients with low pulmonary function and a high Cobb angle were more likely to develop a postoperative pulmonary complication.…”

Section: Discussioncontrasting

confidence: 70%

Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis

Matsumoto

Miyagi

Saito

et al. 2018

Spine Surg Relat Res

View full text Add to dashboard Cite

for Neurological and Psychiatric Disorders of NCNP.The authors declare that there are no conflicts of interest.MiM drafted the manuscript and participated in the design of the study. MaM conceived this study and revised the manuscript. WS, TI, and GI participated in its design and coordination and drafted the manuscript. ES, KU, and TA helped to revise the manuscript and carried out statistical analysis. NT and MT conceived the study and participated in its design and coordination. All the authors have read and have approved the final manuscript.Ethical approval from Institutional Review Board in Kitasato University was obtained for this study, which was conducted in accordance with the ethical principles specified in the 1964 Declaration of Helsinki and its later amendments.The approval code is #B16-236. Results: There were 5 (6%) major complications, including pneumonia and a cardiovascular complication requiring intensive care unit (ICU) care, and 15 (18%) minor complications including viral enteritis and a urinary tract infection.Overall, there were 20 (24%) complications. Three of the 5 major complications were pulmonary. The mean age at the time of surgery was 13.7 y, operative time was 304 min, and blood loss was 1530 ml. The mean preoperative %VC was 41%, FEV 1.0 was 91%, and EF was 60%. When we separated the patients into a group with major complications (n = 5) and a group without major complications (n = 78), the preoperative %VC in the group with major complications (23%) was significantly lower than that in the group without (42%) (p < 0.05). However, operative time, blood loss, preoperative FEV 1.0 (%) and EF between the two groups were not significantly different (p > 0.05). Conclusion:Compared with the previous findings of the perioperative complication rate (45%-74%) for NMS, the complication rate was remarkably low in this case series. Because of advances in medical skills, including anesthesia and surgical instruments, surgery for NMS appears to be safe.However, patients with NMS with complications demonstrated severe restrictive ventilatory impairment preoperatively. Therefore, we should be vigilant for perioperative pulmonary complications especially in patients with NMS and preoperative severe restrictive ventilatory impairment.

show abstract

Section: Discussioncontrasting

confidence: 70%

Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis

Matsumoto

Miyagi

Saito

et al. 2018

Spine Surg Relat Res

View full text Add to dashboard Cite

show abstract

“…Um estudo de Modi et al 8 avaliou complicações cirúrgicas em 50 casos de escoliose neuromuscular tratados por via posterior somente (não havendo pacientes com mielomeningocele) e constatou 6% de complicações com a ferida operatória, sendo um caso de infecção profunda, um superficial e um caso de deiscência da ferida. Considerando os fatores de risco para complicações gerais, eles concordaram com Sponseller et al 2 que a magnitude da curva escoliótica não aumenta o risco de complicações porém, discordaram em outros fatores, relatando que o uso de aloenxerto não é fator e que a perda sanguínea maior que 3500ml é um fator de risco.…”

Section: Objetivo: Las Cirugías De La Columna Vertebral Realizadas Enunclassified

Epidemiologia da infecção pós-operatória em pacientes com mielomeningocele, tratados para correção de deformidades da coluna vertebral

et al. 2011

View full text Add to dashboard Cite

RESUMOObjetivo: As cirurgias de coluna realizadas em pacientes com mielomeningocele, apresentam maior risco de infecção pós-operatória. Fizemos um levantamento epidemiológico dessas infecções e fatores possivelmente associados para estabelecer fatores de risco. Mé-todos: Levantamento retrospectivo de dados de cirurgias de coluna realizadas em pacientes com mielomeningocele, na Associação de Assistência à Criança Deficiente -AACD/Hospital Abreu Sodré. A comparação para possíveis fatores de risco avaliados foi feita através do teste exato de Fisher. Foram considerados significativos os resultados com p < 0,05. Resultados: Avaliamos 27 procedimentos cirúrgicos com um total de sete casos de infecção pós-operatória do sítio cirúrgico (25,92%). Cinco destes pacientes com infecção do sítio cirúrgico apresentaram infecção concomitante do trato urinário (ITU), com p = 0,004. Não encontramos significância estatística para os demais fatores avaliados: via de acesso, tipo de procedimento e linfócitos séricos totais. Conclusão: a ITU está relacionada à infecção do sítio cirúrgico, mas é necessário um estudo prospectivo com maior número de casos para elucidar esse fator de risco com um possível fator de confusão: estado nutricional e imunológico.

show abstract

“…Attention to padding is important to avoid complications such as coccygodynia. 47 Reassessment of the hips should be performed to determine the need for tenotomies to address contractures that may become more prominent after surgery.…”

Section: Other Postoperative Considerationsmentioning

confidence: 99%

Surgical management of spinal deformities in cerebral palsy

Jones-Quaidoo¹,

Yang²,

Arlet³

2010

SPI

View full text Add to dashboard Cite

Cerebral palsy is a nonprogressive encephalopathy caused by a brain dysfunction that occurs during the pre-, peri-, or postnatal phase of development. Cerebral palsy can be characterized by a lack of muscle control with increased spasticity or decreased tone, seizure disorder, and variable mental retardation. The overall incidence of CP is estimated to range from 1 to 5 children per 1000 live births. 49 The overall incidence of scoliosis in the CP population is estimated to range from 21% to 76% depending on the series and whether the patient is a walker or is relegated to sitting due to extensive CP. The incidence and severity of the spinal curve appears to be related to the degree of CP involvement. 39,40 Males are more commonly affected, which is in contrast to idiopathic scoliosis with a female predominance. 49 Scoliotic Curve CharacteristicsPatients with neuromuscular scoliosis may have a variety of scoliotic curve types depending on the severity of CP involvement. Lonstein and Akbarnia 37 characterized the deformity into 2 groups that were most common: 1) Group 1 curves are single thoracic or double thoracic and lumbar curves with a level pelvis, commonly noted in ambulatory patients with CP; and 2) Group 2 curves are long thoracolumbar or C-shaped curves with associated pelvic obliquity, often noted in more involved and dependent patients with CP. Hyperlordosis of the lumbar spine or kyphoscoliosis of the thoracic spine is also a common Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VirginiaCerebral palsy (CP) spinal deformities encompass a spectrum of deformities that are often initially treated nonoperatively, only to result in progression of scoliotic curves and further morbidity. Various surgical interventions have been devised to address the progressive curvature of the spine. This endeavor cannot be taken lightly and at times can be encumbered by prior treatments such as the use of baclofen pumps or dorsal rhizotomies. Care of these patients requires a multidisciplinary approach and comprehensive preoperative and postoperative management, including nutritional status, orthopedic assessment of functional level with specific emphasis on the hips and pelvic obliquity, and wheelchair modifications. The surgical techniques in CP scoliosis have progressively evolved from the classic LuqueGalveston fixation methods, the use of unit rods, and lately the use of pedicle screws, to modern sacropelvic fixation. With the latter method, the spinal deformity in patients with CP can usually be almost completely corrected.

show abstract

Surgical complications in neuromuscular scoliosis operated with posterior- only approach using pedicle screw fixation

Abstract: Although posterior-only approach using pedicle screw fixation had good correction rate, complications were similar to previous reports. There were few unusual complications like coccygodynia.

Cited by 67 publications

References 40 publications

Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis

Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis

Epidemiologia da infecção pós-operatória em pacientes com mielomeningocele, tratados para correção de deformidades da coluna vertebral

Surgical management of spinal deformities in cerebral palsy

Contact Info

Product

Resources

About