MULTICENTER STUDY
Add like
Add dislike
Add to saved papers

Neural complications in the surgical treatment of adolescent idiopathic scoliosis.

Spine 2007 November 16
STUDY DESIGN: Multicenter, prospective, consecutive clinical series.

OBJECTIVE: To report on neural complications in a prospective cohort study of 1301 children undergoing spinal fusion and instrumentation for adolescent idiopathic scoliosis (AIS).

SUMMARY OF BACKGROUND DATA: The incidence of neural complications for spinal deformity surgery has been reported to be 0.26% to 17%. However, most studies have relied on retrospective voluntary reporting of nonconsecutive cases.

METHODS: A review of 1301 consecutive surgical cases was conducted using the Prospective Pediatric Scoliosis Study database, which is maintained by the Spinal Deformity Study Group.

RESULTS: There were 9 neural complications. There were 3 thecal penetrations, none of which required repair, and none of which demonstrated intraoperative neural monitoring changes or postoperative clinical sequelae. There were 2 nerve root injuries. In 1 nerve root injury, a positional compression femoral neurapraxia resolved over 6 months. The other was an L4 neurapraxia despite lowest instrumented vertebra L1, and resolved spontaneously by 3 months' follow-up. There were 4 spinal cord injuries. One required removal of implants and fusion in situ, 1 required relaxation of correction and in situ fusion with instrumentation, while the other 2 were observed after fusion and instrumentation with reduction. All resolved spontaneously within 3 months after operation.

CONCLUSION: The neural complication rate was 0.69%. Two thecal penetrations were due to medial placement of pedicle screws, and 1 was due to dissection during spine exposure. If these are eliminated, as they imply intraspinal entry but not direct neural injury, together with 1 positional neurapraxia, which is remote from the surgical field, our complication rate is 0.38%. This is consistent with other studies in the North American Literature, including multiple reports from the Scoliosis Research Society. Common themes are significant curve correction producing neural stretch and the use of sublaminar wires. None of the neural injuries was permanent. These results reaffirm that surgical treatment of adolescent idiopathic scoliosis has a low but real neural complication rate.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app