Neural Complications in the Surgical Treatment of Adolescent Idiopathic Scoliosis

@article{Diab2007NeuralCI,
  title={Neural Complications in the Surgical Treatment of Adolescent Idiopathic Scoliosis},
  author={Mohammad Diab and Amanda R Smith and Timothy R. Kuklo},
  journal={Spine},
  year={2007},
  volume={32},
  pages={2759-2763}
}
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… 
View on Wolters Kluwer
mst.ru
142 Citations
Highly Influential Citations
1
Background Citations
22
Methods Citations
2

142 Citations

Citation Type

Citation Type

Perioperative and Delayed Major Complications Following Surgical Treatment of Adolescent Idiopathic Scoliosis
TLDR
After surgery for AIS, a 2.6% rate of perioperative major complications and a 4.1% rates of major complications at 2 or more years after surgery can be anticipated, and the complication rate decreased over the period of study.
Neural Complications of Surgical Treatment of Adolescent Idiopathic Scoliosis: a Single Center Experience
TLDR
This study indicates that early detection of neurophysiologic changes using a multimodal approach with SSEPs and Tc-MEPs affords the surgical team an opportunity to perform rapid intervention to prevent injury progression or the possibility to reverse impeding neurologic sequela.
Complications following surgery for adolescent idiopathic scoliosis over a 13-year period.
TLDR
An overall complication rate of 1.5% was found in the authors' series after surgery for AIS, with a reduction of complication rates found in the second period of the analysis.
Using the Freehand Pedicle Screw Placement Technique in Adolescent Idiopathic Scoliosis Surgery: What Is the Incidence of Neurological Symptoms Secondary to Misplaced Screws?
TLDR
During a 12-year period in a dedicated pediatric orthopedic hospital using the freehand placement technique, the incidence of symptomatic misplaced pedicle screws was exceedingly low.
Radiographic Classification of Complications of Instrumentation in Adolescent Idiopathic Scoliosis
TLDR
A new radiographic system of adverse hardware-related events for patients with Type 1 adolescent idiopathic scoliosis is proposed, and among serious radiographic adverse events, the most common problems were revision for lumbar progression, rod breakage, and proximal screw pullout in the anterior spinal fusions and instrumentation removal for pain and infection in the posterior spinal fusion.
Complications in Operative Scheuermann Kyphosis: Do the Pitfalls Differ From Operative Adolescent Idiopathic Scoliosis?
TLDR
Patients with SK are at higher risk for infections and reoperation than those with AIS and the number of levels fused is an independent risk factor for major complications, which are 3.9× more likely to occur in operative SK than in AIS.
Late neurological complications due to laminar hook compression in idiopathic scoliosis surgery
TLDR
Conscientious long-term follow-up of patients undergoing posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS) is important in order to recognize late neurological deficits directly related to instrumentation.
Perioperative Outcome in Posterior Spinal Fusion for Adolescent Idiopathic Scoliosis: A Prospective Study Comparing Single Versus Two Attending Surgeons Strategy
TLDR
The involvement of two attending surgeons significantly reduced operative time, blood loss, need for allogenic blood transfusion, patient-controlled analgesia morphine requirement and led to faster patient recovery during the perioperative period.
Complications of Pedicle Screw Fixation in Scoliosis Surgery: A Systematic Review
TLDR
Malposition is the most commonly reported complication of thoracic pedicle screw placement, at a rate of 15.7% per screw inserted with postoperative computed tomography scans.
Intraoperative neurophysiologic monitoring in idiopathic scoliosis surgery: a retrospective observational study of new neurologic deficits
TLDR
It was revealed that IONM was associated with a reduced overall incidence of NNDs in idiopathic scoliosis correction; however, its impact on the severity of those deficits is questionable.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 18 REFERENCES
Complications in Spinal Fusion for Adolescent Idiopathic Scoliosis in the New Millennium. A Report of the Scoliosis Research Society Morbidity and Mortality Committee
TLDR
This study shows that complication rates are similar for anterior versus posterior approaches to AIS deformity correction, and combined anterior and posterior instrumentation and fusion has double the complication rate of either anterior or posterior instrumentations and fusion alone.
Segmental Spinal Instrumentation in Idiopathic Scoliosis: A Preliminary Report
TLDR
Although segmental instrumentation can be beneficial in idiopathic scoliosis, the incidence of complications, primarily neurologic, will be higher than expected and the major reason appears to be surgeon inexperience with passage of sublaminar wires.
Safety of sublaminar wires with Isola instrumentation for the treatment of idiopathic scoliosis.
TLDR
Despite the increasing complexity of spinal instrumentation systems, sublaminar wire placement is a safe and useful adjunct in the surgical treatment of neurologically intact patients with idiopathic scoliosis.
Acute neurological complications in the treatment of scoliosis. A report of the Scoliosis Research Society.
A survey conducted by the Scoliosis Research Society found eighty-seven patients with acute neurological complications resulting from the treatment of scoliosis. The incidence of these complications…
Safety and Efficacy of Isola Instrumentation and Arthrodesis for Adolescent Idiopathic Scoliosis: Two- to 12-Year Follow-up
TLDR
Isola instrumentation seems to be at least as safe and effective as other instrumentations being used for the surgical treatment of adolescent idiopathic scoliosis, and the principal problems identified were the need for a stronger transverse connector, stable end-instrumented vertebrae foundations, and convex thoracic anchorage.
Complications of Pediatric Thoracolumbar and Lumbar Pedicle Screws
TLDR
Low short‐ and long‐term complication rates specific for pediatric pedicle screws suggests that for properly trained spinal surgeons, pedicle screw fixation in the pediatric population can be performed safely to treat a variety of spinal disorders.
Parents’ and Patients’ Preferences and Concerns in Idiopathic Adolescent Scoliosis: A Cross-Sectional Preoperative Analysis
TLDR
Although parents and patients had similar ratings and concerns, the parents’ concerns were higher, and expectations were greater than the patients’, and the highest expectation and main reason for having the surgery was to reduce future pain and disability as an adult.
Postoperative neurological deficits in segmental spinal instrumentation. A study using spinal cord monitoring.
TLDR
With spinal cord monitoring the authors were able to predict the impending major neurological deficits, but the transient (sensory) changes that may be associated with segmental wiring were less reliably predicted.
In Vivo Accuracy of Thoracic Pedicle Screws
TLDR
The accuracy of thoracic screw placement within the pedicle and vertebral body and the resultant transverse screw angle (TSA) were assessed by postoperative CT and the incidence of fully contained screws was directly correlated with the region of instrumentedThoracic spine.
A Biomechanical Analysis of Sublaminar and Subtransverse Process Fixation Using Metal Wires and Polyethylene Cables
TLDR
This is the first biomechanical study to compare the stability afforded by sublaminar fixation and subtransverse process fixation using metal wire and UHMWPE cable before and after cyclic loading.
...
1
2
...