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[Neurologic complications of surgery for spinal deformities]
1Hôpital E. Herriot, Chirurgie orthopèdique, Lyon.
Chirurgie; Memoires De L'Academie De Chirurgie
|January 1, 1994
Summary
Neurological complications after spinal deformity surgery, particularly medullary damage, can be severe. Advances in monitoring and surgical techniques have significantly reduced their occurrence.
Area of Science:
- Neurosurgery
- Orthopedic Surgery
- Spinal Deformity Correction
Context:
- Spinal deformity surgery carries risks of neurological complications, including medullary damage.
- A review of 667 cases from 1980-1990 identified 33 complications, with 17 being medullary.
- Factors like secondary etiology, kyphosis, and spinal cord status influenced complication rates.
Purpose:
- To analyze the incidence, nature, and influencing factors of neurological complications in spinal deformity surgery.
- To evaluate the relationship between complication timing, severity, and neurological outcomes.
- To discuss management strategies, including material removal in emergencies.
Summary:
- The study reviewed 667 spinal deformity surgeries (1980-1990), finding a 2.5% rate of medullary complications, including paraplegia.
- Secondary causes, kyphosis, and a 'spinal cord at risk' status increased complication rates.
- Delayed complications were more severe, highlighting the importance of neurological monitoring and surgical technique.
Impact:
- Identified key risk factors for medullary complications in spinal deformity surgery.
- Emphasized the severity of late-onset neurological deficits.
- Highlighted improvements in surgical outcomes due to advanced monitoring (e.g., evoked potentials) and technique refinement (e.g., abandoning sublaminal wiring).