Surgical Risk Stratification Based on Preoperative Risk Factors in Severe Pediatric Spinal Deformity Surgery

Boachie-Adjei, Oheneba; Yagi, Mitsuru; Sacramento-Dominguez, Cristina; Akoto, Harry; Cunningham, Matthew E.; Gupta, Munish C.; Hess, W. Fred; Lonner, Baron S.; Ayamga, Jennifer; Papadopoulus, Elias; Sanchez-Perez-Grueso, Federico; Pelise, Feran; Paonessa, Kenneth J.; Kim, Hee Jin

doi:10.1016/j.jspd.2014.05.004

Cited by 24 publications

(34 citation statements)

References 22 publications

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“…In a review of 145 pediatric spinal deformities, the authors introduced a scoring system Foundation of Orthopedics and Complex Spine (FOCOS level) that included these two factors and found that the FOCOS level correlated with blood loss, operation duration, and complication rate. 30 Suk et al in his study on single-staged VCR in 16 patients, reported 3 major complications; 1 had acute complete paralysis, 1 had hematoma, and 1 had hemopneumothorax. 7 Riley et al reviewed 109 patients who underwent posterior VCR for severe spinal deformity.…”

Section: Discussionmentioning

confidence: 98%

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Chan

Chung

Mihara

et al. 2020

J Orthop Surg (Hong Kong)

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Purpose: Various surgical strategies including combined approach and spinal osteotomies in severe rigid scoliosis had been reported with significant perioperative complication rates. The use of single-staged posterior spinal fusion (PSF) utilizing a dual attending surgeon strategy for severe rigid scoliosis has not been widely reported. Methods: This was a retrospective study aimed to evaluate the perioperative outcome of single-staged PSF in severe rigid idiopathic scoliosis patients (Cobb angle ≥90° and ≤30% flexibility). Forty-one patients with severe rigid idiopathic scoliosis who underwent single-staged PSF were included. The perioperative outcome parameters were operation duration, intraoperative blood loss, intraoperative hemodynamic parameters, preoperative and postoperative hemoglobin, transfusion rate, patient-controlled anesthesia morphine usage, length of postoperative hospital stay, and perioperative complications. Radiological parameters included preoperative and postoperative Cobb angle, correction rate, side-bending flexibility, and side-bending correction index. Results: The mean age was 16.9 ± 5.6 years. The mean preoperative Cobb angle was 110.8 ± 12.1° with mean flexibility of 23.1 ± 6.3%. The mean operation duration was 215.5 ± 45.2 min with mean blood loss of 1752.6 ± 830.5 mL. The allogeneic blood transfusion rate was 24.4%. The mean postoperative hospital stay was 76.9 ± 26.7 h. The mean postoperative Cobb angle and correction rate were 54.4 ± 12.8° and 50.9 ± 10.1%, respectively. The readmission rate in this cohort was 2.4%. Four perioperative complications were documented (9.8%), one somatosensory evoke potential signal loss, one superficial infection, one lung collapse, and one superior mesenteric artery syndrome. Conclusions: Severe rigid idiopathic scoliosis treated with single-staged PSF utilizing a dual attending surgeon strategy demonstrated an average correction rate of 50.9%, operation duration of 215.5 min, and postoperative hospital stay of 76.9 h with a 9.8% perioperative complication rate.

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Section: Discussionmentioning

confidence: 98%

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Chan

Chung

Mihara

et al. 2020

J Orthop Surg (Hong Kong)

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“…Supervised learning (i.e., classification and regression) uses input features (X) to predict a defined outcome (Y), while unsupervised learning (i.e., clustering) involves analyzing input variables (X) to elucidate patterns and structure in the data. Supervised learning algorithms can predict rare events such as surgical complications 20 and have the potential to improve patient risk stratification, clinical decision making, informed consent and health service planning 18,[21][22][23][24][25] . Supervised learning has been used in DBS surgery to predict clinical outcomes 26,27 , surgical targets 28,29 , side effects 30 , discharge status 31 and neurophysiological detection of DBS structures [32][33][34] .…”

Section: Introductionmentioning

confidence: 99%

Investigating Risk Factors and Predicting Complications in Deep Brain Stimulation Surgery with Machine Learning Algorithms

et al. 2020

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Транспедикулярная спинальная система позволяет достичь полноценной коррекции врожденной деформации после удаления тела аномального позвонка с опорой только на соседние интактные тела позвонков относительно порочного [3, 14,16]. Однако при установке транспедикулярной металлоконструкции существует ряд технических сложностей и проблем, а также риск возникновения различного рода осложнений, прежде всего неврологического характера [17,18].…”

Section: Discussionunclassified

Analysis of causes of metal structure destabilization in correction of congenital spinal deformation in children of a younger age group

Kokushin

Николаевич²,

Vissarionov

et al. 2020

Pediatr Traum Orthop Reconstr Surg

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Background. One of the most common vertebral malformations that lead to the occurrence and progression of congenital scoliosis is disorders of vertebral formation. Most specialists adhere to the active tactics of surgical correction of spinal deformity in early childhood. The aim. To evaluate the variants and causes of the transpedicular spinal system destabilization, which is not related to the violation of its integrity, in the surgical treatment of children with congenital spinal deformities. Materials and methods. The case histories of 286 children under the age of 6 years undergoing surgical treatment in H. Turner National Medical Research Center for Сhildrens Orthopedics and Trauma Surgery between 2014 and 2019 were analyzed. Depending on the outcome of the surgical treatment, the patients were divided into groups: the main group (n = 7) included those with spinal system destabilization and the control group (n = 12) consisted of those without spinal system destabilization. During the study, the sizes of the bases of the arcs adjacent to the abnormal vertebra, the magnitude of the scoliotic and kyphotic components of the deformation, and the correct position of the supporting elements of the spinal system on the Gertzbein scale were determined. Results. Patients of the studied groups were identified according to their age and the magnitude of scoliotic and kyphotic components of spinal deformity. The average diameter of the arc base in the studied groups varied (p 0.05). In all patients, the complete correction of the congenital curvature of the spine was achieved after surgery. In the long-term postoperative period in patients of the study group after radiation analysis, the malposition of supporting elements relative to the base of the vertebral arch and a loss of correction of spinal deformity by an average of 25 were revealed, which required the repeated surgery in order to restore the stability of the spinal system and to correct deformation. Conclusions. The reasons for the spinal system destabilization during the correction of the spinal congenital deformations are the peculiarities of vertebral anatomical-anthropometric parameters in the curvature zone, as well as tactical aspects during surgery. The main reason for the spinal system destabilization without violating its integrity is the small size of bases of adjacent vertebral arches relative to the abnormal one. The small size of the bases of the vertebral arches and the significant amount of necessary correction of congenital spinal deformity necessitate the installation of a longer spinal system in order to restore physiological profiles in the curvature zone.

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Surgical Risk Stratification Based on Preoperative Risk Factors in Severe Pediatric Spinal Deformity Surgery

Cited by 24 publications

References 22 publications

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Perioperative outcome of severe rigid idiopathic scoliosis: Single-staged posterior spinal fusion utilizing a dual attending surgeon strategy. A report of 41 patients

Investigating Risk Factors and Predicting Complications in Deep Brain Stimulation Surgery with Machine Learning Algorithms

Analysis of causes of metal structure destabilization in correction of congenital spinal deformation in children of a younger age group

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