Perioperative Complications of Pedicle Subtraction Osteotomy

Daubs, Michael D.; Brodke, Darrel S.; Annis, Prokopis; Lawrence, Brandon D.

doi:10.1055/s-0035-1570088

Cited by 42 publications

(27 citation statements)

References 18 publications

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“…Other authors have looked at outcomes of PSO in the lumbar spine in the treatment of large sagittal deformities of the lumbar spine. In the literature, PSO complications are generally analyzed as 2 tipes: minor or major complication [12,13].…”

Section: Resultsmentioning

confidence: 99%

Blood Loss of Pedicle Subtraction Osteotomy for Sagittal Imbalance Spinal Deformity

Abu-Awwad¹,

Prejbeanu²,

Vermeşan³

et al. 2019

Rev. Chim.

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Pedicle subtraction osteotomies (PSO) have been used in the treatment of multiple spinal conditions involving a fixed sagittal imbalance. It is a complex, extensive surgery most often performed in the revision settings. The aim of our study is to review the major complications of this surgical technique with a focus on blood loss. Twenty patients were included, treated using PSO for sagittal imbalance, out of 255 corrective surgeries. Of the 12 female patients included in the study, the mean age was 64.33. Of the 8 male patients included in the study, the mean age was 51.85. For female patients, the mean blood loss was 2122.5 mL in comparison with male patients, with mean blood loss 1737.5 mL. The female patients had an operating time of 357.25 minutes in comparasion with male patients with an 328.5 minute operating time. Eight (5 female and 3 male) had postoperative neurological deficits and 6 (5 female and 1 male) had pseudarthrosis of adjacent levels.

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Section: Resultsmentioning

confidence: 99%

Blood Loss of Pedicle Subtraction Osteotomy for Sagittal Imbalance Spinal Deformity

Abu-Awwad¹,

Prejbeanu²,

Vermeşan³

et al. 2019

Rev. Chim.

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“…2,4 Their use is only justified because sagittal correction is of great importance in the context of adult deformities, since it has been shown that pain and disability are directly related to an increased SVA and changes in sagittal spinopelvic parameters. [13][14][15] When considering a three-column osteotomy, the decision making process should take the possibility of not achieving sufficient correction or of having postoperative loss of correction into account, [5][6][7][8] since the procedure is subject to various complications and mechanical failures, and may also be impacted by reinterventions that may occur.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] Their use is justified by the importance of sagittal correction in surgeries for deformity, but few articles describe how much of this correction is maintained because of complications that occur and the duration of follow-up in these cases. 5,6 This study surveys the mechanical complications and the evolution of sagittal spinopelvic measurements of a series of 20 patients with sagittal imbalance who underwent three-column osteotomies with follow-up for at least one year.…”

Section: Introductionmentioning

confidence: 99%

“…Infections and mechanical complications, such as junctional kyphosis, pseudoarthrosis, and loosening or fracture of implants, are the most common causes of reinterventions. 4,16 The most frequent mechanical complications in the series was rod breakage, which occurred seven times in six cases (30%), followed by failure of the lower segment of the fixation, which occurred four times in three cases (15%). The cases of lower failure were interpreted as problems with the surgical technique for not having instrumented enough segments.…”

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confidence: 98%

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Mechanical Complications and Loss of Correction in Osteotomies of the Three Columns

2017

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Objectives: To observe the degree of correction and postoperative evolution of the spinopelvic parameters in patients with sagittal imbalance submitted to 3-column osteotomies. Methods: Retrospective analysis of 20 cases of 3-column osteotomies in patients with evident sagittal imbalance and minimum follow-up of one year, computing evolution of radiological data as a function of time, complications and reinterventions, and classification into subgroups by preoperative spinopelvic measures and complications. The variation of measures, quantitative and categorical variables, and differences between groups were evaluated using the Wilcoxon, Spearman, Fischer's exact test, Kruskal-Wallis and Mann-Whitney tests. Results: There was improvement of all the sagittal parameters, ideal correction in 55% of the cases and maintained until the end of the follow-up in 40% of the cases. No correlation was found between obtaining optimal correction and data or preoperative measurements. Clinical and infectious complications did not affect the maintenance of the correction. The most common mechanical complications were pseudoarthrosis-related rod fracture at osteotomy (30%) and failures at the lower fixation level (15%). There was no significant difference in the maintenance of the correction between the groups with and without mechanical complications treated. In the untreated mechanical complications there was a significantly higher radiological worsening (p<0.05) in the maintenance parameters of the curve correction (loss of 27. MECHANICAL COMPLICATIONS AND LOSS OF CORRECTION IN OSTEOTOMIES OF THE THREE COLUMNS COMPLICAÇÕES MECÂNICAS E PERDA DE CORREÇÃO EM OSTEOTOMIAS DAS TRÊS COLUNAS COMPLICACIONES MECÁNICAS Y PÉRDIDA DE CORRECCIÓN EN OSTEOTOMÍAS DE LAS TRES COLUMNAS

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“…Eine Studie von Daubs. et al [44] berichtet über eine Komplikationsrate innerhalb der ersten 3 Monate nach erfolgter PSO von 31 %. Eine weitere Studie von Bridwell et al [45] berichtet über 20 "early-onset" und 12 "late-onset" Komplikationen bei 66 Patienten, welche eine PSO der Lendenwirbelsäule erhielten.…”

Section: Operative Versorgung Und Managementunclassified

Adulte Skoliosen

2019

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ZusammenfassungDurch die global alternde Bevölkerung tritt die degenerative Lumbalskoliose (DLS) im Erwachsenenalter immer mehr in den Vordergrund und repräsentiert somit einen Großteil der spinalen Deformitäten. Durch die schleichende Progredienz der Erkrankung entsteht ein massiver Leidensdruck der Patienten. Die konservative Therapie der DLS zeigt ernüchternde Resultate, weshalb bei Versagen der nicht-chirurgischen Behandlungskonzepte häufig die operative Therapie indiziert wird. Neben relativ simplen Dekompressionen für milde Formen der DLS mit isolierten klaudikativen bzw. radikulären Beschwerden, können komplexe und komplikationsreiche Wirbelkörperosteotomien sowie kombinierte ventro-dorsale Eingriffe zur Anwendung kommen. Klassifikationssysteme und Einteilungen dienen zur Graduierung der Deformität und können bei der Wahl der adäquaten operativen Technik bzw. dem Ausmaß des operativen Eingriffs hilfreich sein. Neben der primären koronaren Korrektur sollte insbesondere eine sagittale Korrektur erfolgen, da das sagittale Profil einen engen Zusammenhang mit der Patientenzufriedenheit aufweist und zudem Einfluss auf die Progression der Deformität haben kann. Dieser Artikel soll einen Überblick zur degenerativen Lumbalskoliose als Hauptvertreter der adulten Skoliosen und ihren Behandlungsmöglichkeiten geben.

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Perioperative Complications of Pedicle Subtraction Osteotomy

Cited by 42 publications

References 18 publications

Blood Loss of Pedicle Subtraction Osteotomy for Sagittal Imbalance Spinal Deformity

Blood Loss of Pedicle Subtraction Osteotomy for Sagittal Imbalance Spinal Deformity

Mechanical Complications and Loss of Correction in Osteotomies of the Three Columns

Adulte Skoliosen

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