scholarly journals Predictors of postoperative urinary retention after posterior spinal fusion for adolescent idiopathic scoliosis

Author(s):  
Tommi Yrjälä ◽  
Linda Helenius ◽  
Markku Taittonen ◽  
Hanna Oksanen ◽  
Heli Keskinen ◽  
...  

Abstract Purpose To determine predictors for postoperative urinary retention in adolescents undergoing posterior spinal fusion for idiopathic scoliosis. Postoperative urinary retention affects almost every third adolescent after spinal fusion for idiopathic scoliosis. There are limited data regarding the risk factors of postoperative urinary retention in this patient group. Methods A retrospective study with prospectively collected urinary retention data from paediatric spine register with 159 consecutive patients (114 females, mean age 15.6 years, range 10–21 years) undergoing pedicle screw instrumentation for adolescent idiopathic scoliosis at a university hospital between May 2010 and April 2020. Postoperative urinary retention was defined as an inability to void after catheter removal and documented residual over 300 mL as confirmed using an ultrasound or by catheterization. Results Postoperative urinary retention was diagnosed in 33% (53 of 159) of the patients during hospital stay. Opioid amount on the day of catheter removal (OR 6.74 [95% CI: 2.47, 18.36], p < 0.001), male gender (OR 2.26 [95% CI: 1.01, 5.05], p = 0.048), and increasing weight (OR 1.04 [95% CI: 1.01, 1.07], p = 0.014) were associated with postoperative urinary retention. Mean opioid consumption on the day of catheter removal was 0.81 mg/kg (95% CI: 0.66, 0.96) in the retention group vs 0.57 mg/kg (95% CI: 0.51, 0.64) in the non-retention group, p < 0.001. Conclusions Higher total opioid consumption, opioid amount on the day of catheter removal, higher weight, and male gender increases the risk of postoperative urinary retention in adolescents with idiopathic scoliosis undergoing posterior spinal fusion.

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chris Yuk Kwan Tang ◽  
Vijay H. D. Kamath ◽  
Prudence Wing Hang Cheung ◽  
Jason Pui Yin Cheung

Abstract Background Adolescent idiopathic scoliosis (AIS) is a common spinal deformity. Posterior spinal fusion remains an important surgical treatment for AIS. This study aims to determine the predictive factors for intraoperative blood loss in AIS surgery. Methods Patients who had undergone posterior spinal fusion for adolescent idiopathic scoliosis in a single university hospital were reviewed over a 7-year period. Predictive factors for intra-operative blood loss were studied by multivariate analysis to derive a regression model. Receiver operating characteristic analysis was performed to determine the cut-off values of factors contributing to significant intraoperative blood loss (≥500 ml). Results Two hundred and twelve patients were included. Intraoperative blood loss was found to be correlated with gender (rs = 0.30 (0.17–0.43)), preoperative hemoglobin level (rs = 0.20 (0.04–0.31)), preoperative Cobb angle (rs = 0.20 (0.02–0.29)), number of fused levels (rs = 0.46 (0.34–0.58)), operation duration (rs = 0.65 (0.54–0.75)), number of anchors (rs = 0.47 (0.35–0.59)), and p-value ranged from < 0.001 to < 0.05. Significant intraoperative blood loss was influenced by the male gender, operation duration greater than 257.5 min and more than 10 anchors used. Conclusions Male gender, increased operation duration and higher number of anchors predicted higher intra-operative blood loss.


2019 ◽  
Vol 40 (7) ◽  
pp. e629-e633
Author(s):  
Andrew B. Harris ◽  
Majd Marrache ◽  
Varun Puvanesarajah ◽  
Micheal Raad ◽  
Richard L. Skolasky ◽  
...  

Spine ◽  
2017 ◽  
Vol 42 (8) ◽  
pp. 603-609 ◽  
Author(s):  
Kazunori Hayashi ◽  
Hidetomi Terai ◽  
Hiromitsu Toyoda ◽  
Akinobu Suzuki ◽  
Masatoshi Hoshino ◽  
...  

Author(s):  
Aladine A. Elsamadicy ◽  
Isaac G. Freedman ◽  
Andrew B. Koo ◽  
Wyatt B. David ◽  
John Havlik ◽  
...  

2018 ◽  
Vol 6 (2) ◽  
pp. 137-140 ◽  
Author(s):  
Lawrence L. Haber ◽  
Erika D. Womack ◽  
Madhankumar Sathyamoorthy ◽  
James A. Moss ◽  
Michael Wade Shrader

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