Perioperative Major Non-neurological Complications in 105 Patients Undergoing Posterior Vertebral Column Resection Procedures for Severe Rigid Deformities

Wang, Yingsong; Xie, Jingming; Zhao, Zhi; Zhang, Ying; Li, Tao; Bi, Ni; Liu, Zhou; Chen, Leijie; Shi, Zhiyue

doi:10.1097/brs.0000000000000995

Cited by 22 publications

(18 citation statements)

References 19 publications

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“…Wang and colleagues described that PVCR is a reconstruction of the trunk of the body which contains the heart, great vessels, and respiratory organs. It is reported that respiratory-related complications are more frequent, because severe spinal deformity is often associated with respiratory function impairment [ 24 ]. We were able to identify that 12.1% of the total complications related to an internal organ (5.6% were respiratory complications).…”

Section: Discussionmentioning

confidence: 99%

Total Deformity Angular Ratio as a Risk Factor for Complications after Posterior Vertebral Column Resection Surgery

Lee

Hyun

Han

et al. 2018

J Korean Neurosurg Soc

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ObjectiveThe aim of the present study was to identify whether the deformity angular ratio (DAR) influences the occurrence of complications after posterior vertebral column resection (PVCR) and to establish the DAR cut-off value. MethodsThirty-six consecutive patients undergoing PVCR from December 2010 to October 2016 were reviewed. The relationships between the total, sagittal, and coronal DAR and complications were assessed using receiver operator characteristics curves. The patients were divided into two groups according to a reference value based on the cut-off value of DAR. Demographic, surgical, radiological, and clinical outcomes were compared between the groups. ResultsThere were no significant differences in the patient demographic and surgical data between the groups. The cut-off values for the total DAR (T-DAR) and the sagittal DAR (S-DAR) were 20.2 and 16.4, respectively (p=0.018 and 0.010). Both values were significantly associated with complications (p=0.016 and 0.005). In the higher T-DAR group, total complications (12 vs. 21, p=0.042) and late-onset complications (3 vs. 9, p=0.036) were significantly correlated with the T-DAR. The number of patients experiencing complications (9 vs. 11, p=0.029) and the total number of complications (13 vs. 20, p=0.015) were significantly correlated with the S-DAR. Worsening intraoperative neurophysiologic monitoring was more frequent in the higher T-DAR group (2 vs. 4) than in the higher S-DAR group (3 vs. 3). There was no difference in neurological deterioration between the groups after surgery. ConclusionBoth the T-DAR and the S-DAR are risk factors for complications after PVCR. Those who had a T-DAR >20.2 or S-DAR >16.4 experienced a higher rate of complications after PVCR.

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Section: Discussionmentioning

confidence: 99%

Total Deformity Angular Ratio as a Risk Factor for Complications after Posterior Vertebral Column Resection Surgery

Lee

Hyun

Han

et al. 2018

J Korean Neurosurg Soc

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“…According to a review of the literature, our group found that the prognostic factors related to AL could generally be divided into the following 4 categories: patient-related factors, symptomatic factors, radiographic factors, and surgical factors. [1][2]5,[7][8]10,12,14,19,25 Currently, with the routine use of MRI and CT, fractures or nonfusion of the facet joints can be detected at an early stage, which can facilitate the accurate diagnosis and the assessment of prognostic related to the outcomes of AL. [16][17]19,24 Chang et al 25 in AS in relation to JOA recovery rate.…”

Section: Discussionmentioning

confidence: 99%

“…For patients treated with surgery, the average JOA score was 9.1 ± 1.5 (range 5.5-14) on admission and 13.2 ± 2.2 (range 7. [5][6][7][8][9][10][11][12][13][14][15][16][17] at the final follow-up. In the conservative treatment group, the average JOA score was 11.5 ± 2.9 (range 6.5-14) on admission and 12.1 ± 0.8 (range 8.5-16) at the final follow-up.…”

Section: Joa Scorementioning

confidence: 99%

Effects of Andersson lesion treatment in ankylosing spondylitis: A medical record review study focused on medium‐ to long‐term outcomes

Yan

Ping

et al. 2020

Int J of Rheum Dis

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The present study aimed to evaluate the clinical efficacy of Andersson lesion (AL) treatments and prognostic factors using medium-to long-term follow-up data and discuss the clinical characteristics and treatment of AL. Forty-eight consecutive AL cases at our center from June 2011 to March 2018 were retrospectively analyzed, including 13 cases treated conservatively and 35 treated surgically. Epidemiological characteristics, treatment modalities, clinical features and outcomes, and prognostic factors of the Japanese Orthopaedic Association (JOA) recovery rate were reviewed. Neurological functional recovery was evaluated by American Spinal Injury Association (ASIA) classification. Clinical efficacy was evaluated by JOA score, visual analog scale (VAS) score, and Cobb's angle. The mean overall follow-up duration was 44.5±18.5 months (range, 27-85 months). There were 36 male and 12 female patients, with a mean age of 49.4±13.1 years (range, 26-72 years). The most common lesion location was the thoracolumbar region, i.e., T10-L2 (n=33; 68.8%), followed by the thoracic (n=10) and lumbar (n=5) regions. Patients treated surgically showed significantly better JOA scores, VAS scores and Cobb's angles at the final follow-up than did patients treated conservatively (P<.05). Univariate and binary logistic regression analyses identified two prognostic factors of the JOA score recovery rate: treatment modality (OR=0.157; 95%CI, 0.028-0.89; P=.036) and bone fusion (OR=9.965; 95%CI, 2.052-48.387; P=.004). Conservative treatment and bone nonunion predict worse JOA score recovery. Surgery remains the optimal treatment for AL in ankylosing spondylitis patients, with better clinical efficacy demonstrated by medium-to long-term follow-up data.

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“…Currently, spinal kyphosis is primarily treated with osteotomy and posterior fusion (Wang et al 2015, Zhou et al 2018, Hua et al 2019, Zhang et al 2019. However, performing a vertebral osteotomy via a posterior approach is difficult when a kyphosis is "folded" or the lumbar spine is collapsed.…”

Section: Why Was Hpt Necessary For the 3 Patients?mentioning

confidence: 99%

Halo-pelvic traction for extreme lumbar kyphosis: 3 rare cases with a completely folded lumbar spine

Wang

Liu

et al. 2020

Acta Orthopaedica

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Perioperative Major Non-neurological Complications in 105 Patients Undergoing Posterior Vertebral Column Resection Procedures for Severe Rigid Deformities

Abstract: 3.

Cited by 22 publications

References 19 publications

Total Deformity Angular Ratio as a Risk Factor for Complications after Posterior Vertebral Column Resection Surgery

Total Deformity Angular Ratio as a Risk Factor for Complications after Posterior Vertebral Column Resection Surgery

Effects of Andersson lesion treatment in ankylosing spondylitis: A medical record review study focused on medium‐ to long‐term outcomes

Halo-pelvic traction for extreme lumbar kyphosis: 3 rare cases with a completely folded lumbar spine

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