Novel posterior technique to temporize life-threatening hemorrhage after great vessel laceration during posterior osteotomy

Cheng, Wayne K.; Ta, Phillip; Abou-Zamzam, Ahmed M.; Akpolat, Yusuf T.; Guillen, Phillip T.

doi:10.1007/s00586-015-3944-8

Cited by 3 publications

(2 citation statements)

References 12 publications

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“…No matter what kind of osteotomies 12,13,14 , these procedures generally improve kyphotic deformity by shortening the posterior column and lengthening the anterior column. Ji et al 12 found that aortic length increased by 2.2 cm averagely after closing-opening wedge osteotomy and the amount of aortic lengthening correlated positively with the degree of kyphosis correction, indicating that the aorta was more vulnerable to get injured in correction of more severe kyphotic deformities.…”

Section: Discussionmentioning

confidence: 99%

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Jiang

Liao

et al. 2022

Preprint

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Background. The position of the aorta relative to the spine in kyphosis secondary to ankylosing spondylitis is little understood. The purpose of this study was to investigate the anatomic relationship between the aorta and the spine in patients with Pott's deformity and to compare it with the normal people.Methods. Seventy-six patients with Pott's deformity (Group TB) and seventy-two age- and sex-matched patients with a normal spine (group NC) were enrolled in this study. The relative position of aorta to the spine was evaluated from T4 to L4 on the computed tomographic angiography scans for controls and at the apex level for TB patient, and was classified into 4 kinds of degrees. Results. The left pedicle-aorta angle in group TB was significantly larger than that in group NC at the T6-L3 levels. Group TB exhibited significantly smaller left pedicle-aorta distance, pedicular line-aorta distance and vertebra/rib-aorta distance than those in group NC at the T5-T10 levels, but bigger at the L1-3 levels. Patients with grade 3 and 4 aorta had more segments involved compared with those with grade 1 aorta. Patients with grade 2, 3, and 4 aorta showed larger kyphotic angles than those with grade 1.Conclusions. Patients whose morbid segments involved only thoracic vertebrae presented with an “Ω” shaped aorta in sagittal plane, and 4 different kinds of degrees of aorta relative to the vertebra/rib in axial plane. Patients whose morbid segments covered lumbar vertebrae presented with an “M” shaped aorta in sagittal plane, and the aorta shifted further from apex vertebra but was located in close proximity to the vertebral body at levels above and below the osteotomy levels in axial plane.

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Section: Discussionmentioning

confidence: 99%

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Jiang

Liao

et al. 2022

Preprint

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“…2 ). Although the vascular complication is rare, the consequence may be quite devastating [ 13 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Different angular kyphosis locations have different relative positions of aorta to spine in patients with Pott’s deformity

Liao

Gao

et al. 2022

BMC Musculoskelet Disord

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Background The position of the aorta relative to the spine in kyphosis secondary to Pott's deformity is little understood. The purpose of this study was to investigate the anatomic relationship between the aorta and the spine in patients with Pott’s deformity and to compare it with the normal people. Methods Seventy-six patients with Pott’s deformity (Group TB) and seventy-two age- and sex-matched patients with a normal spine (group NC) were enrolled in this study. The relative position of aorta to the spine was evaluated from T4 to L4 on the computed tomographic angiography scans for controls and at the apex level for TB patient, and was classified into 4 kinds of degrees. Results The left pedicle-aorta angle in group TB was significantly larger than that in group NC at the T6-L3 levels. Group TB exhibited significantly smaller left pedicle-aorta distance, pedicular line-aorta distance and vertebra/rib-aorta distance than those in group NC at the T5-T10 levels, but bigger at the L1-3 levels. Patients with grade 3 and 4 aorta had more segments involved compared with those with grade 1 aorta. Patients with grade 2, 3, and 4 aorta showed larger kyphotic angles than those with grade 1. Conclusions Patients whose morbid segments involved only thoracic vertebrae presented with an “Ω” shaped aorta in sagittal plane, and 4 different kinds of degrees of aorta relative to the vertebra/rib in axial plane. Patients whose morbid segments covered lumbar vertebrae presented with an “M” shaped aorta in sagittal plane, and the aorta shifted further from apex vertebra but was located in close proximity to the vertebral body at levels above and below the osteotomy levels in axial plane.

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Strategy for Surgical Correction of Thoracolumbar Kyphosis Caused by Ankylosing Spondylitis

Chen

2023

J. Musculoskelet. Res.

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Various osteotomy techniques have been proposed to correct the kyphotic deformities caused by ankylosing spondylitis (AS). However, no technique could cater to all AS-related deformities well regarding the various mobility of calcified discs and the severity of deformities. Therefore, a thorough understanding of the strength and weaknesses of each method is essential. Then, a strategic approach could be formulated to select the most appropriate technique for a specific patient so as to have a correction operation with effectiveness, safety, and surgical simplicity. Among all preoperative examinations, the evaluation of disc mobility and the severity of kyphotic deformity is mandatory, which constitutes the base for the selection of osteotomy techniques. Since posterior column osteotomy (PCO) is the simplest technique, it should be used as much as possible. If up to three mobile discs are preserved, and the severity of the deformity is only moderate, e.g. the global thoracolumbar angle is less than 60[Formula: see text], contemporary poly-segmental PCO is selected. Staged PCO (SPCO), proposed by the authors, is the enhanced PCO with more excellent correction capability. If the disc mobility is not favorable enough, SPCO can be considered instead. PSO is the most versatile technique, capable of correcting all kinds of deformities regardless of disc mobility and severity of the kyphosis. This technique can be used in every case if surgical complexity is not a concern to the operator. Especially, PSO is the exclusive indication for those firmly ankylosed deformities without any mobile disc.

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Novel posterior technique to temporize life-threatening hemorrhage after great vessel laceration during posterior osteotomy

Abstract: The posterior peri-vertebral approach can potentially be used by a spine surgeon during a life-threatening situation to temporarily occlude great vessel hemorrhage while waiting for the assistance of a vascular/trauma team.

Cited by 3 publications

References 12 publications

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Different Angular Kyphosis Locations Have Different Relative Positions of Aorta to Spine in Patients with Pott's Deformity

Different angular kyphosis locations have different relative positions of aorta to spine in patients with Pott’s deformity

Strategy for Surgical Correction of Thoracolumbar Kyphosis Caused by Ankylosing Spondylitis

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