Impact of spine surgery on signs and symptoms of spinal deformity

Abstract Purpose of Review This article describes the anatomy of the spine, relevant ultrasonographic views, and the techniques used to perform the neuraxial blocks using ultrasound imaging. Finally, we review the available evidence for the use of ultrasound imaging to perform neuraxial blocks. Recent Findings Central neuraxial blockade using traditional landmark palpation is a reliable technique to provide surgical anesthesia and postoperative analgesia. However, factors like obesity, spinal deformity, and previous spine surgery can make the procedure challenging. The use of ultrasound imaging has been shown to assist in these scenarios. Summary Preprocedural imaging minimizes the technical difficulty of spinal and epidural placement with fewer needle passes and skin punctures. It helps to accurately identify the midline, vertebral level, interlaminar space, and can predict the depth to the epidural and intrathecal spaces. By providing information about the best angle and direction of approach, in addition to the depth, ultrasound imaging allows planning an ideal trajectory for a successful block. These benefits are most noticeable when expert operators carry out the ultrasound examination and for patients with predicted difficult spinal anatomy. Recent evidence suggests that pre-procedural neuraxial ultrasound imaging may reduce complications such as vascular puncture, headache, and backache. Neuraxial ultrasound imaging should be in the skill set of every anesthesiologist who routinely performs lumbar or thoracic neuraxial blockade. We recommend using preprocedural neuraxial imaging routinely to acquire and maintain the imaging skills to enable success for challenging neuraxial procedures.

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Predictive model for major complications 2 years after corrective spine surgery for adult spinal deformity

European Spine Journal ◽

10.1007/s00586-018-5816-5 ◽

2018 ◽

Vol 28 (1) ◽

pp. 180-187 ◽

Cited By ~ 4

Author(s):

Mitsuru Yagi ◽

Naobumi Hosogane ◽

Nobuyuki Fujita ◽

Eijiro Okada ◽

Osahiko Tsuji ◽

...

Keyword(s):

Predictive Model ◽

Spine Surgery ◽

Spinal Deformity ◽

Adult Spinal Deformity ◽

Major Complications

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Adult Spinal Deformity in the Elderly. Preliminary Clinical and Radiological Results in 22 Patients Treated by a Two Times Minimally Invasive Spine Surgery

Global Spine Journal ◽

10.1055/s-0036-1582843 ◽

2016 ◽

Vol 6 (1_suppl) ◽

pp. s-0036-1582843-s-0036-1582843

Author(s):

Marco Cimatti ◽

Stefano Forcato ◽

Massimo Miscusi ◽

Alessandro Frati ◽

Filippo Maria Polli ◽

...

Keyword(s):

Minimally Invasive ◽

Spine Surgery ◽

Spinal Deformity ◽

Adult Spinal Deformity ◽

The Elderly ◽

Minimally Invasive Spine Surgery ◽

Radiological Results ◽

Minimally Invasive Spine ◽

Clinical And Radiological Results

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Does corrective spine surgery improve the standing balance in patients with adult spinal deformity?

The Spine Journal ◽

10.1016/j.spinee.2017.05.023 ◽

2018 ◽

Vol 18 (1) ◽

pp. 36-43 ◽

Cited By ~ 12

Author(s):

Mitsuru Yagi ◽

Hideaki Ohne ◽

Shinjiro Kaneko ◽

Masafumi Machida ◽

Yoshiyuki Yato ◽

...

Keyword(s):

Spine Surgery ◽

Spinal Deformity ◽

Adult Spinal Deformity ◽

Standing Balance

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Principles of spine surgery

Oxford Textbook of Rheumatology ◽

10.1093/med/9780199642489.003.0092_update_002 ◽

2013 ◽

pp. 705-711

Author(s):

Jeremy Fairbank ◽

Nuno Batista

Keyword(s):

Chronic Pain ◽

Bone Strength ◽

Spine Surgery ◽

Spinal Deformity ◽

Sagittal Balance ◽

Loss Of Function ◽

Limited Role ◽

Disabled Patients ◽

Spine Surgeon

Spine surgery addresses pain, loss of function and deformity of the spine. Earlier conceptions of chronic pain have changed, but there is still a limited role for surgery to manage painful spinal pathology. Loss of function is caused by tumours, fractures and infections, all of which can be helped by surgery. Deformity is called scoliosis and/or kyphosis, and be corrected by surgery. Spinal deformity is increasingly recognized in adults as an important cause of disability, especially when there is loss of sagittal balance. Advances in anaesthesia and implant technology have allowed the spine surgeon greater opportunities to help seriously disabled patients in ways not possible 20 years ago. Fractures occur following trauma, but are also associated with impaired bone strength, particularly through osteoporosis.

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Minimally Invasive Spine Surgery in Spinal Deformity

Contemporary Spine Surgery ◽

10.1097/01.css.0000582388.91225.27 ◽

2019 ◽

Vol 20 (10) ◽

pp. 8

Keyword(s):

Minimally Invasive ◽

Spine Surgery ◽

Spinal Deformity ◽

Minimally Invasive Spine Surgery ◽

Minimally Invasive Spine

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Characteristics and Risk Factors of Rod Fracture Following Adult Spinal Deformity Surgery: A Systematic Review and Meta-Analysis

Neurospine ◽

10.14245/ns.2040832.416 ◽

2021 ◽

Vol 18 (3) ◽

pp. 447-454

Author(s):

Sung Hyun Noh ◽

Kyung Hyun Kim ◽

Jeong Yoon Park ◽

Sung Uk Kuh ◽

Keun Su Kim ◽

...

Keyword(s):

Risk Factors ◽

Spine Surgery ◽

Spinal Deformity ◽

Adult Spinal Deformity ◽

Weighted Mean Difference ◽

Advanced Age ◽

Smoking History ◽

Cochrane Library ◽

Sagittal Vertical Axis ◽

Rod Fracture

Objective: The aim of study is to investigate the features and risk factors of rod fracture (RF) following adult spinal deformity (ASD) surgery.Methods: We searched the PubMed, Embase, Web of Science, and Cochrane Library databases to identify relevant studies. Patient’s data including age, sex, body mass index (BMI), previous spine surgery, pedicle subtraction osteotomy (PSO), interbody fusion, fusion to the pelvis, smoking history, preoperative sagittal vertical axis (SVA), preoperative pelvic tilt (PT), preoperative pelvic incidence minus lumbar lordosis, preoperative thoracic kyphosis (TK), and change in the SVA were documented. Comparable factors were evaluated using odds ratio (OR) and weighted mean difference (WMD) with 95% confidence interval (CI).Results: Seven studies were included. The overall incidence of RF following ASD surgery was 12%. Advanced age (WMD, 2.8; 95% CI, 1.01–4.59; p < 0.002), higher BMI (WMD, 1.98; 95% CI, 0.65–3.31; p = 0.004), previous spine surgery (OR, 1.47; 95% CI, 1.05–2.04; p = 0.02), PSO (OR, 2.28; 95% CI, 1.62–3.19; p < 0.0001), a larger preoperative PT (WMD, 6.17; 95% CI, 3.55–8.97; p < 0.00001), and a larger preoperative TK (WMD, 5.19; 95% CI, 1.41–8.98; p = 0.007) were identified as risk factors for incidence of RF.Conclusion: The incidence of RF in patients following ASD surgery was 12%. Advanced age, higher BMI, previous spine surgery, and PSO were significantly associated with an increased occurrence of RF. A larger preoperative PT and TK were also identified as risk factors for occurrence of RF following ASD surgery.

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Principles of spine surgery

10.1093/med/9780199642489.003.0092 ◽

2013 ◽

Author(s):

Jeremy Fairbank ◽

Nuno Batista

Keyword(s):

Chronic Pain ◽

Bone Strength ◽

Spine Surgery ◽

Spinal Deformity ◽

Sagittal Balance ◽

Loss Of Function ◽

Limited Role ◽

Disabled Patients ◽

Spine Surgeon

Spine surgery addresses pain, loss of function and deformity of the spine. Earlier conceptions of chronic pain have changed, but there is still a limited role for surgery to manage painful spinal pathology. Loss of function is caused by tumours, fractures and infections, all of which can be helped by surgery. Deformity is called scoliosis and/or kyphosis, and be corrected by surgery. Spinal deformity is increasingly recognized in adults as an important cause of disability, especially when there is loss of sagittal balance. Advances in anaesthesia and implant technology have allowed the spine surgeon greater opportunities to help seriously disabled patients in ways not possible 20 years ago. Fractures occur following trauma, but are also associated with impaired bone strength, particularly through osteoporosis.

Download Full-text