Early outcomes and complications of posterior vertebral column resection

Papadopoulos, E.; Boachie-Adjei, Oheneba; Hess, W. Fred; Pérez-Grueso, Francisco Javier Sánchez; Pellisé, Ferràn; Gupta, Munish C.; Lonner, Baron S.; Paonessa, Kenneth J.; Faloon, Michael; Cunningham, Matthew E.; Kim, Hee Jin; Mendelow, Michael J.; Sacramento, Christina; Yazıcı, Muharrem

doi:10.1016/j.spinee.2013.03.023

Cited by 87 publications

(72 citation statements)

References 19 publications

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“…All patients with IONM changes in the study by Papadopolous et al [47] had chronic spinal cord compression. Another study found substantially better outcomes after decompression for hyperkyphosis secondary to Pott's disease in patients with active versus healed disease [60].…”

Section: Kyphosismentioning

confidence: 86%

“…Anterior-posterior approaches in the thoracic spine have become less common than posterior-only techniques because of the difficulty approaching the curve concavity in large deformities, pulmonary complications from transthoracic approaches, and concern of SCI from anterior distraction forces [47]. Additionally, posterior-only procedures with instrumented fusion have been shown to provide adequate deformity correction with lower neural complications than combined approaches [41,48].…”

Section: Anteriormentioning

confidence: 99%

“…Wang et al [58] evaluated the safety of posterior-only vertebral column resection (VCR) in 24 patients with sharp, Papadopoulos et al [47] reported on 45 hyperkyphotic patients treated by posterior-only VCR for congenital and posttuberculous kyphosis. Average preoperative kyphosis measured 108°and improved to 60°postoperatively.…”

Section: Kyphosismentioning

confidence: 99%

“…Transient nerve root injuries are the most common neurological complication of 3-COs performed by a posterior-only approach [39,47,74,75] although SCI is also an established complication. Bianco et al [19] reported on 423 ASD patients who underwent three-column osteotomies at eight centers.…”

Section: Three-column Osteotomiesmentioning

confidence: 99%

“…Motor-evoked potentials (MEPs) are commonly used in conjunction with SSEPs because they evaluate the corticospinal motor tracts and nerve roots better. In the series by Papadopoulos et al [47], nearly 98 % of patients with IONM changes were managed by intraoperative protocols and avoided neurologic sequelae. IONM is invaluable in the management of ASD and especially in patients with hyperkyphosis, double major curve patterns, and other extreme curvatures.…”

Section: Intraoperative Neuromonitoringmentioning

confidence: 99%

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Neurological complications in adult spinal deformity surgery

Iorio

Reid

Kim

2016

Curr Rev Musculoskelet Med

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The number of surgeries performed for adult spinal deformity (ASD) has been increasing due to an aging population, longer life expectancy, and studies supporting an improvement in health-related quality of life scores after operative intervention. However, medical and surgical complication rates remain high, and neurological complications such as spinal cord injury and motor deficits can be especially debilitating to patients. Several independent factors potentially influence the likelihood of neurological complications including surgical approach (anterior, lateral, or posterior), use of osteotomies, thoracic hyperkyphosis, spinal region, patient characteristics, and revision surgery status. The majority of ASD surgeries are performed by a posterior approach to the thoracic and/or lumbar spine, but anterior and lateral approaches are commonly performed and are associated with unique neural complications such as femoral nerve palsy and lumbar plexus injuries. Spinal morphology, such as that of hyperkyphosis, has been reported to be a risk factor for complications in addition to three-column osteotomies, which are often utilized to correct large deformities. Additionally, revision surgeries are common in ASD and these patients are at an increased risk of procedure-related complications and nervous system injury. Patient selection, surgical technique, and use of intraoperative neuromonitoring may reduce the incidence of complications and optimize outcomes.

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Section: Kyphosismentioning

confidence: 86%