Abstract:
STUDY DESIGN:Prognostic study-case controlled. OBJECTIVE:Describe the rate of neurologic complications in adult spinal deformity surgery and describe the effect of these complications on clinical outcomes. SUMMARY OF BACKGROUND DATA:The incidence of neurologic complications and the risk factors for neurologic complications have not been reported in a large series of patients with adult spinal deformity (ASD). Existing series include a mixed patient cohort undergoing different types of spine surgery. METHODS:Patients with ASD undergoing surgery between 2008 and 2014 were analyzed. Patients with neurologic complications were identified; demographics, operative details, and radiographic and clinical outcomes were compared. A subanalysis of those with surgical and nonsurgical (e.g., stroke) neurologic complications was performed. Statistical analysis included t tests or χ tests as appropriate and a multivariate analysis. A P value of less than 0.025 was considered significant. RESULTS:A total of 564 patients met the inclusion criteria. The average age was 57 years. There were a total of 116 neurologic complications in 99 patients (17.6%). There were 88 surgical procedure-related neurologic complications in 77 patients (13.7%) and 28 nonsurgical neurologic complications in 28 patients (5.0%). The most common complications were radiculopathy (30%), motor deficits (22%), mental status changes (12%), and sensory deficits (12%). Revisions (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.2-2.4) and interbody fusions (OR 2.1, 95% CI 1.4-3.2) were associated with an increased risk of neurologic complications. Decompression and osteotomies (including three-column osteotomies) did not increase the risk of neurologic complications. Patients with neurologic complications were not more likely to sustain other complications; however, they were more likely to undergo another operation during the follow-up period (OR 1.9, 95% CI 1.3-2.8). CONCLUSION:The overall incidence of neurologic complications in ASD surgery was 17.6%. The incidence of surgical neurologic complications was 13.7%. There was a higher risk of neurologic complications in revision cases and in cases in which interbody fusion was required. LEVEL OF EVIDENCE:3.
journal_name
Spine (Phila Pa 1976)journal_title
Spineauthors
Kim HJ,Iyer S,Zebala LP,Kelly MP,Sciubba D,Protopsaltis TS,Gupta M,Neuman BJ,Mundis GM,Ames CP,Smith JS,Hart R,Burton D,Klineberg EO,International Spine Study Group (ISSG).doi
10.1097/BRS.0000000000001774subject
Has Abstractpub_date
2017-03-15 00:00:00pages
420-427issue
6eissn
0362-2436issn
1528-1159pii
00007632-201703150-00018journal_volume
42pub_type
杂志文章相关文献
SPINE文献大全abstract:STUDY DESIGN:Prospective, longitudinal cohort (nonrandomized). OBJECTIVE:To compare thoracoplasty (Th), direct vertebral body derotation (DVBD), and Th and DVBD with respect to correction of the rib prominence and Scoliosis Research Society (SRS) self-image scores in patients undergoing surgery for adolescent idiopath...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31824a4911
更新日期:2012-06-15 00:00:00
abstract:STUDY DESIGN:A prospective case study was performed. OBJECTIVES:To illustrate the association of cervical trauma with vertebral artery dissection, and to propose a diagnostic and therapeutic algorithm for suspected traumatic vertebral artery dissection. SUMMARY OF BACKGROUND DATA:Vertebral artery dissection is a reco...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200102010-00019
更新日期:2001-02-01 00:00:00
abstract:STUDY DESIGN:A comparative evaluation of outcome instruments and global assessment was performed. OBJECTIVE:To test patient global assessment as a substitute for the use of more comprehensive outcome instruments in treatment trials of chronic low back pain. SUMMARY OF BACKGROUND DATA:Treatment outcome can be measured...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200206010-00014
更新日期:2002-06-01 00:00:00
abstract:STUDY DESIGN:A biomechanical study was designed to assess relative rigidity provided by anterior, posterior, or combined cervical fixation using cadaveric cervical spine models for flexion-distraction injury and burst fracture. OBJECTIVES:To compare the construct stability provided by anterior plating with locked fixa...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200101010-00005
更新日期:2001-01-01 00:00:00
abstract::The mixed results of two studies on intradiscal therapy with collagenase versus chymopapain are presented. The first study was performed from January 1983 to March 1984 and consisted of 71 patients treated with collagenase injection (600 ABC units) and 93 patients treated with chymopapain injection (4,000 units) into ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198705000-00016
更新日期:1987-05-01 00:00:00
abstract:STUDY DESIGN:A retrospective analysis. OBJECTIVE:This study aimed to compare the safety and efficacy between the fusion-nonfusion hybrid construct (HC: anterior cervical corpectomy and fusion plus artificial disc replacement, ACCF plus cADR) and anterior cervical hybrid decompression and fusion (ACHDF: anterior cervic...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000588
更新日期:2014-11-01 00:00:00
abstract:STUDY DESIGN:Pragmatic, multicentered randomized controlled trial, with 12-month follow-up. OBJECTIVE:To evaluate the effect of adding specific spinal stabilization exercises to conventional physiotherapy for patients with recurrent low back pain (LBP) in the United Kingdom. SUMMARY OF BACKGROUND DATA:Spinal stabiliz...
journal_title:Spine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/01.brs.0000232787.71938.5d
更新日期:2006-09-01 00:00:00
abstract::Effects of subject positions on range and repeatability of thoracic and lumbar forward flexion, extension, and lateral flexion were studied. Inclinometric methods were used, and 27 subjects were measured by two trained testers. No great differences in repeatability and range of movements were found between measurement...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199109000-00016
更新日期:1991-09-01 00:00:00
abstract::Anterior stabilization with combined plate and bone fusion was performed after neural decompression on ten patients for spondylotic cervical myelopathy, and for radiculopathy or trauma in three patients. Medial corpectomy was performed at one to four levels. Iliac crest or fibular bone grafts were secured by plates an...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198803000-00003
更新日期:1988-03-01 00:00:00
abstract:STUDY DESIGN:Clinical, neuroradiologic, and neurophysiologic description of 21 patients with compressive cervical spondylotic myelopathy (CCSM). OBJECTIVE:To describe the utility of cutaneous silent periods (CSPs) for functional evaluation of mild CCSM. SUMMARY OF BACKGROUND DATA:Electroneurography, electromyography,...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31818f8be3
更新日期:2009-01-01 00:00:00
abstract::Knowledge of the normal movements of whole lumbar spine and lumbosacral joint is important for evaluating clinical pathologic conditions that may potentially produce unstable situations in these regions. At present there are few studies that report systemic three-dimensional movement analysis of these regions. The pur...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198911000-00020
更新日期:1989-11-01 00:00:00
abstract:STUDY DESIGN:A technical report of fluoroscopically assisted percutaneous translaminar facet screw fixation after anterior lumbar interbody fusion (ALIF). OBJECTIVES:To describe a minimally invasive translaminar facet screw fixation technique that was modified from the Magerl method, and to assess its technical feasib...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000157473.17313.6f
更新日期:2005-04-01 00:00:00
abstract:STUDY DESIGN:Thirty-five lumbar disc herniations removed at surgery were studied by indirect immunocytochemistry. OBJECTIVES:To localize immunohistochemically both sensory and autonomic nerve terminals in disc herniations. SUMMARY OF BACKGROUND DATA:Using various more or less specific histologic and histochemical met...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199606010-00004
更新日期:1996-06-01 00:00:00
abstract:STUDY DESIGN:A case report. OBJECTIVE:To describe an effective surgical option for sacral tuberculosis (TB). SUMMARY OF BACKGROUND DATA:Sacral TB is a rare cause of low back pain. A differential diagnosis of TB should always be made, especially in India where TB cases are on a rampant rise with increasing drug resist...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3182540579
更新日期:2012-06-15 00:00:00
abstract:STUDY DESIGN:A prospective double-blind randomized trial in 31 patients. OBJECTIVES:To assess the clinical efficacy of percutaneous radiofrequency denervation of the lumbar zygapophysial joints in reducing pain, functional disability, and physical impairment in patients with back pain originating from the lumbar zygap...
journal_title:Spine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007632-199909150-00013
更新日期:1999-09-15 00:00:00
abstract:STUDY DESIGN:Narrative review of the literature and commentary. OBJECTIVE:To discuss from an epidemiological and sociological perspective whether the early clinical management of whiplash-associated disorders can lead to iatrogenic disability. SUMMARY OF BACKGROUND DATA:There is a lack of evidence supporting the effe...
journal_title:Spine
pub_type: 杂志文章,评审
doi:10.1097/BRS.0b013e3182388d32
更新日期:2011-12-01 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical study to evaluate the stability of different types of instrumentation in the lumbar spine following corpectomy in relation to bone mineral density (BMD). OBJECTIVES:To investigate the relation between the stability of a spinal instrumentation and BMD. To determine a threshold value ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/01.brs.0000161000.36376.c5
更新日期:2005-05-01 00:00:00
abstract::Several authors have previously reported the complications resulting from contact between a diagnostic or therapeutic agent injected into an intervertebral disc and neural tissue. This study was undertaken to demonstrate the common routes by which, and frequency with which this contact occurs. Of 105 cadaveric interve...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:1991-02-01 00:00:00
abstract:STUDY DESIGN:A biomechanical study using human cadaveric cervical spines was conducted. OBJECTIVE:To determine whether the cervical stability achieved with lateral mass fixation using unicortical screw purchase is comparable with that obtained with lateral mass fixation using bicortical screw purchase. SUMMARY OF BAC...
journal_title:Spine
pub_type: 杂志文章
doi:
更新日期:2003-04-15 00:00:00
abstract:STUDY DESIGN:Cross-sectional study with repeated measures design. OBJECTIVE:To compare the myosin heavy-chain isoform distribution within and between paraspinal muscles and to test the theory that fiber-type gradients exist as a function of paraspinal muscle depth. SUMMARY OF BACKGROUND DATA:There is still uncertaint...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181bfcd98
更新日期:2010-06-01 00:00:00
abstract:STUDY DESIGN:The effects of electrical stimulation of the sciatic nerve on background electromyographic and static stretch reflex activity of the trunk muscles were studied. OBJECTIVES:To verify the hypotheses that sciatic scoliosis is induced reflexively by radiculopathic pain, and that scoliosis might be maintained ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-200103150-00009
更新日期:2001-03-15 00:00:00
abstract:STUDY DESIGN:A prospective cohort study of Cobb angles (CA) and apical vertebral rotations (AVR) in 25 patients who had adolescent idiopathic scoliosis. OBJECTIVE:To assess in vivo the concomitant vertebral derotation occurring with correction of scoliosis deformity as a result of coupling effect by using the fulcrum ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e31824f108f
更新日期:2012-07-01 00:00:00
abstract:STUDY DESIGN:Retrospective database analysis. OBJECTIVE:A range of patient-reported outcomes were used to measure disability due to low back pain. There is not a single back pain disability measurement commonly used in all randomized controlled trials. We report here our assessment as to whether different disability m...
journal_title:Spine
pub_type: 杂志文章,meta分析
doi:10.1097/BRS.0000000000000866
更新日期:2015-05-15 00:00:00
abstract::A case of aplastic arch of the atlas (Keller's type) with severe injury to the cervical spine is presented. The impact of the accident was intense enough to produce bony compression of the C7 vertebra, but no injury occurred to the neural elements in the upper cervical spine. The presence of the ligamentous apparatus ...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-198304000-00001
更新日期:1983-04-01 00:00:00
abstract:STUDY DESIGN:The effect of an EP1 receptor antagonist on pain-related behavior induced by nucleus pulposus (NP) applied to the dorsal root ganglion (DRG) in rats was investigated. OBJECTIVE:We investigated pain-related behavior, the amount of prostaglandin E2 (PGE2), and neural damage to the DRG after application of N...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0b013e3181fa1fca
更新日期:2011-10-15 00:00:00
abstract:STUDY DESIGN:A randomized controlled trial. OBJECTIVE:To investigate feed-forward activation or timing of abdominal muscle activation in response to rapid shoulder flexion after 8 weeks with core stability exercises, sling exercises, or general exercises in chronic nonspecific low back pain (LBP) patients. SUMMARY OF...
journal_title:Spine
pub_type: 杂志文章,随机对照试验
doi:10.1097/BRS.0b013e318241377c
更新日期:2012-06-01 00:00:00
abstract:STUDY DESIGN:Retrospective. OBJECTIVE:To examine the relationship between American Society of Anesthesiologists (ASA) score and inpatient pain and narcotics consumption following anterior cervical discectomy and fusion (ACDF). SUMMARY OF BACKGROUND DATA:Higher ASA scores have been previously linked to increased posto...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000003135
更新日期:2019-11-15 00:00:00
abstract:STUDY DESIGN:In vitro biomechanical investigation. OBJECTIVE:To assess differences in kyphosis after balloon kyphoplasty (BKP) or vertebral body stenting (VBS). SUMMARY OF BACKGROUND DATA:Cement augmentation techniques allow early mobilization in patients with osteoporotic thoracolumbar fractures. Biomechanically, th...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000000470
更新日期:2014-09-01 00:00:00
abstract::Segmental spinal instability was evaluated with magnetic resonance (MR) imaging, computed tomography (CT), and conventional radiography in 33 patients who had undergone surgical spinal fusion. In 16 of the 19 patients who had a diagnosis of solid fusion, the immobilized vertebral bodies demonstrated areas of high sign...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/00007632-199006000-00028
更新日期:1990-06-01 00:00:00
abstract:STUDY DESIGN:Retrospective review. OBJECTIVE:To report the incidence of and risk factors for intraoperative cardiopulmonary arrest (ICA) in children undergoing spinal deformity surgery. SUMMARY OF BACKGROUND DATA:Spinal deformities in children are associated with comorbidities that can pose substantial risks during s...
journal_title:Spine
pub_type: 杂志文章
doi:10.1097/BRS.0000000000001105
更新日期:2015-11-01 00:00:00