Iatrogenic spinal cord injury: an observational study

Abstract

Study design: Retrospective descriptive observational study. Objective: The primary objective of this study was to quantify the incidence of iatrogenic spinal cord injury (SCI) at our SCI unit (SCIU). The secondary objective was to discover the surgical and medical procedures that cause iatrogenic SCI and to estimate the incidence with each procedure. Subjects: Patients admitted to or seen at outpatient services of the SCIU at a university hospital. Methods: Histories were compiled from 1 July 2005 to 30 June 2009. We included patients with SCI caused by any medical or surgical procedure. We collected age, sex, diagnosis leading to medical intervention, predominant clinical manifestations, medical-surgical procedure and level and grade of injury upon admission and discharge. Results: Out of 250 patients admitted to the SCIU, 32 (14.7%) patients presented iatrogenic SCI. Average age was 56.2 (s.d. 17.3), ranging from 0 to 82 years old. The most frequent clinical manifestation was pain. The most common diagnosis was channel stenosis. Lumbar level grade C of American Spine Injury Association (ASIA) was the most frequently observed. Conclusion: The rise in the population's life expectancy entails an increase in elderly patients with vascular risk factors, who underwent invasive interventions leading to spinal cord iatrogenia.

Epidemiology of Traumatic Spinal Cord Injury in Ireland, 2010–2015

“…Although this is a separate aetiology in the ISCoS core dataset and is usually reported as a distinct category [22], it was more appropriate in this study to include it with “other” causes for statistical purposes. Iatrogenic injuries (15 cases, 4.3% of total number of TSCI) were less common than those reported in Spain (10–18.2%) but more common than those reported in the previous study of TSCI epidemiology in Ireland (2%) [2, 23, 24]. …”

Risk Factors of Iatrogenic Spinal Cord Injury in Spinal Surgery: A Multicenter Retrospective Study

“…Previous study suggested that risk of iatrogenic SCI may be related to age [1,2]. In this study, the average age of patients in the research group was 42.48 ± 16.41, which was much elder than 30.05 ± 8.06 of the control group (p < .05), the difference suggested that elder patients would more easily suffer from iatrogenic SCI.…”

“…Alcanyis-Alberola et al reported 14.7% (32/250) patients with SCI were caused by iatrogenic mechanisms [1]. Because it results in deterioration of motor, sensory, or autonomie function of the spinal cord involved, iatrogenic SCI lowers patients' quality of life, increases length of stay (LOS) in hospitals, and brings heavy mental and financial burdens to victims and their families.…”

Rapid fluorescence imaging of spinal cord following epidural administration of a nerve-highlighting fluorophore

“…Iatrogenic spinal cord injury (SCI) is the most devastating complication of spine surgery with the incidence of approximately 0% to 2%, generally less than 1% 3-5. The iatrogenic SCI usually results in chronic pain, loss of sensory and motor function, paralysis, and is even life-threatening 6, 7. The spinal cord is soft, thin, fragile and lies deeply in narrow space, leading to increased operation complexity and ultra-low fault tolerance during spine surgery 1, 2, 8.…”