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Paraplegia resulting from vessel ligation
R B Winter1, J E Lonstein, F Denis
1Minnesota Spine Center, Minneapolis, USA.
Study Design:
This is a retrospective review of clinical records for evidence of paraplegia specifically resulting from segmental vessel ligation during anterior spinal surgery.
Objectives:
To determine the precise risk rate, and to potentially identify risk factors.
Summary Of Background Data:
Although many authors have alluded to this risk, the exact risk rate and risk factors have never been identified.
Methods:
All patients having an anterior approach involving T1-L3 were reviewed. The two reviewers were not involved in any of the surgeries. The 1197 cases were consecutive from 1967 to 1991.
Results:
There were no paralyses.
Conclusions:
There would appear to be virtually no risk to segmental vessel ligation provided: 1) vessel ligation is unilateral, 2) done on the convexity of a scoliosis, 3) ligated at midvertebral body level, and 4) hypotensive anesthesia is avoided. Soft clamping with somatosensory-evoked potential monitoring does not appear justified.