A clinical study regarding the outcomes of symptomatic spinal epidural haematoma after adult spinal deformity surgery

2020 ◽  
pp. 1-12
Author(s):  
Shao Qiang Liu ◽  
Wei Chen ◽  
Gui Qing Liang ◽  
Zhong Liao ◽  
Qiang Qi
Keyword(s):  
Clinical Study ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Epidural Haematoma ◽  
Neurological Deficits ◽  
Spinal Epidural Haematoma ◽  
Spinal Deformity Surgery ◽  
Spinal Epidural ◽  
Frankel Grade

Abstract Symptomatic spinal epidural haematoma (SSEH) is a rare but serious postoperative complication. This study aimed to assess the prevalence, causes and treatment of SSEH after adult spinal deformity (ASD) surgery. The patients admitted from August 2012 till August 2016 were retrospectively reviewed using case notes. During these four years, 102 patients were admitted with adult spinal deformity, out of which 3 (2.9%) developed post-operative SSEH. The duration between surgery to onset of SSEH was 10-13 hours (average 11.7 hours) post-operatively. Three patients were treated by haematoma evacuation at 8.5-14 hour (average 11.4 hours) after the symptoms appeared. One patient had improved by 2 Frankel grades, and two patients had improved by1 Frankel grade at the last follow-up. The results concluded that post-operative SSEH occurred in 2.9% of ASD patients who underwent corrective spinal procedures. Improvement in neurological deficits can be achieved by early haematoma evacuation. Continuous..... 

Impact of resolved early major complications on 2-year follow-up outcome following adult spinal deformity surgery

2019 ◽  
Vol 28 (9) ◽  
pp. 2208-2215
Author(s):  
Susana Núñez-Pereira ◽  
◽  
Ferran Pellisé ◽  
Alba Vila-Casademunt ◽  
Ahmet Alanay ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Major Complications ◽  
Spinal Deformity Surgery

A Critical Analysis of Sagittal Plane Deformity Correction with Minimally Invasive Adult Spinal Deformity Surgery: A Two-Year Follow-Up Study

2015 ◽  
Vol 15 (10) ◽  
pp. S126-S127
Author(s):  
International Spine Study Group ◽  
Gregory M. Mundis ◽  
Jay D. Turner ◽  
Vedat Deviren ◽  
Juan S. Uribe ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Spinal Deformity ◽  
Critical Analysis ◽  
Sagittal Plane ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Follow Up Study ◽  
Spinal Deformity Surgery ◽  
Plane Deformity

Recovery following adult spinal deformity surgery: the effect of complications and reoperation in 149 patients with 2-year follow-up

2015 ◽  
Vol 25 (8) ◽  
pp. 2612-2621 ◽  
Author(s):  
Justin K. Scheer ◽  
◽  
Gregory M. Mundis ◽  
Eric Klineberg ◽  
Robert A. Hart ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinal Deformity Surgery

Risk Factor Analysis for PJK After Adult Spinal Deformity Surgery: A New Simple Scoring System Based on 417 Patients with Two-Year Follow-Up

2017 ◽  
Vol 17 (10) ◽  
pp. S187-S188
Author(s):  
Renaud Lafage ◽  
Frank J. Schwab ◽  
Eric O. Klineberg ◽  
Douglas C. Burton ◽  
Shay Bess ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Risk Factor ◽  
Spinal Deformity ◽  
Scoring System ◽  
Adult Spinal Deformity ◽  
Risk Factor Analysis ◽  
Spinal Deformity Surgery

Opioid use after adult spinal deformity surgery: patterns of cessation and associations with preoperative use

2020 ◽  
Vol 33 (4) ◽  
pp. 490-495
Author(s):  
Mark Ren ◽  
Barry R. Bryant ◽  
Andrew B. Harris ◽  
Khaled M. Kebaish ◽  
Lee H. Riley ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
High Dose ◽  
Opioid Use ◽  
Postoperative Time ◽  
Spinal Deformity Surgery ◽  
Preoperative Factors ◽  
Time Point

OBJECTIVEThe objectives of the study were to determine, among patients with adult spinal deformity (ASD), the following: 1) how preoperative opioid use, dose, and duration of use are associated with long-term opioid use and dose; 2) how preoperative opioid use is associated with rates of postoperative use from 6 weeks to 2 years; and 3) how postoperative opioid use at 6 months and 1 year is associated with use at 2 years.METHODSUsing a single-center, longitudinally maintained registry, the authors identified 87 patients who underwent ASD surgery from 2013 to 2017. Fifty-nine patients reported preoperative opioid use (37 high-dose [≥ 90 morphine milligram equivalents daily] and 22 low-dose use). The duration of preoperative use was long-term (≥ 6 months) for 44 patients and short-term for 15. The authors evaluated postoperative opioid use at 6 weeks, 3 months, 6 months, 1 year, and 2 years after surgery. Multivariate logistic regression was used to determine associations of preoperative opioid use, dose, and duration with use at each time point (alpha = 0.05).RESULTSThe following preoperative factors were associated with opioid use 2 years postoperatively: any opioid use (adjusted odds ratio [aOR] 14, 95% CI 2.5–82), high-dose use (aOR 7.3, 95% CI 1.1–48), and long-term use (aOR 17, 95% CI 2.2–123). All patients who reported high-dose opioid use at the 2-year follow-up examination had also reported preoperative opioid use. Preoperative high-dose use (aOR 247, 95% CI 5.8–10,546) but not long-term use (aOR 4.0, 95% CI 0.18–91) was associated with high-dose use at the 2-year follow-up visit. Compared with patients who reported no preoperative use, those who reported preoperative opioid use had higher rates of use at each postoperative time point (from 94% vs 62% at 6 weeks to 54% vs 7.1% at 2 years) (all p < 0.001). Opioid use at 2 years was independently associated with use at 1 year (aOR 33, 95% CI 6.8–261) but not at 6 months (aOR 4.3, 95% CI 0.95–24).CONCLUSIONSPatients’ preoperative opioid use, dose, and duration of use are associated with long-term use after ASD surgery, and a high preoperative dose is also associated with high-dose opioid use at the 2-year follow-up visit. Patients using opioids 1 year after ASD surgery may be at risk for long-term use.

scholarly journals Pulmonary Function Following Adult Spinal Deformity Surgery: Minimum Two-Year Follow-Up

2013 ◽  
Vol 13 (9) ◽  
pp. S156
Author(s):  
Ronald A. Lehman ◽  
Daniel G. Kang ◽  
Lawrence G. Lenke ◽  
Brenda A. Sides
Keyword(s):  
Pulmonary Function ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Spinal Deformity Surgery

Comorbid Psychiatric Diagnoses Are Associated with Poor Outcomes of Adult Spinal Deformity Surgery at Two-Year Follow-Up

2017 ◽  
Vol 17 (10) ◽  
pp. S178
Author(s):  
Bassel G. Diebo ◽  
Joshua D. Lavian ◽  
George Beyer ◽  
Frank A. Segreto ◽  
Patrick J. Mixa ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Psychiatric Diagnoses ◽  
Spinal Deformity Surgery ◽  
Poor Outcomes

Postoperative changes in neurological function after 3-column osteotomy: risk factor analysis of 199 patients

2019 ◽  
Vol 30 (5) ◽  
pp. 568-573 ◽  
Author(s):  
Morsi Khashan ◽  
Micheal Raad ◽  
Mostafa H. El Dafrawy ◽  
Varun Puvanesarajah ◽  
Khaled M. Kebaish
Keyword(s):  
Risk Factors ◽  
Spinal Deformity ◽  
Neurological Deficit ◽  
Adult Spinal Deformity ◽  
Care Center ◽  
Tertiary Care ◽  
Neurological Deficits ◽  
High Grade ◽  
Postoperative Changes

OBJECTIVEThe authors evaluated the neurological outcomes of adult spinal deformity patients after 3-column osteotomy (3CO), including severity and long-term improvement of neurological complications, as well as risk factors for neurological deficit at 1 year postoperatively. Although 3CO is effective for correcting rigid spinal deformity, it is associated with a high complication rate. Neurological deficits, in particular, cause disability and dissatisfaction.METHODSThe authors retrospectively queried a prospective database of adult spinal deformity patients who underwent vertebral column resection or pedicle subtraction osteotomy between 2004 and 2014 by one surgeon at a tertiary care center. The authors included 199 adults with at least 1-year follow-up. The primary outcome measure was change in lower-extremity motor scores (LEMSs), which were obtained preoperatively, within 2 weeks postoperatively, and at 6 and 12 months postoperatively. To identify risk factors for persistent neurological deficit, the authors compared patient and surgical characteristics with a declined LEMS at 12-month follow-up (n = 10) versus those with an improved/maintained LEMS at 12-month follow-up (n = 189).RESULTSAt the first postoperative assessment, the LEMS had improved in 15% and declined in 10% of patients compared with preoperative scores. At the 6-month follow-up, 6% of patients continued to have a decline in LEMS, and 16% had improvement. At 12 months, LEMS had improved in 17% and declined in 5% of patients compared with preoperative scores. The only factor significantly associated with a decline in 12-month LEMS was high-grade spondylolisthesis as an indication for surgery (OR 13, 95% CI 3.2–56).CONCLUSIONSAlthough the LEMS declined in 10% of patients immediately after 3CO, at 12 months postoperatively, only 5% of patients had neurological motor deficits. A surgical indication of high-grade spondylolisthesis was the only factor associated with neurological deficit at 12 months postoperatively.

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