Surgical treatment of adolescent idiopathic scoliosis: Complications

Al-Mohrej, Omar A.; Aldakhil, Sahar S.; Al-Rabiah, Mohammed A.; Al-Rabiah, Anwar M

doi:10.1016/j.amsu.2020.02.004

Cited by 51 publications

(36 citation statements)

References 45 publications

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“…While the evidence was not statistically significant, it showed an improvement in the adult group but not in the pediatric group [9]. From the data and subjective opinions, this type of surgery has had the highest success rate within the blood conservation program at this hospital, and the implementation of swab washing and use of appropriate bowl sizes made a huge contribution to the reduction in the units of blood used and in avoiding transfusion.…”

Section: Discussionmentioning

confidence: 83%

“…Similar data showed that postoperative infection was reduced when allogenic transfusions were avoided in patients undergoing primary arthroplasty [8]. Al-Mohrej et al found that surgical interventions for patients with idiopathic scoliosis were generally correlated with intraoperative bleeding that necessitated transfusion, which in turn increased the risk of infection and wound complications [9]. It also costs the hospital in terms of length of stay, pain relief, antibiotic cover, and possibly prolonged home care [10].…”

Section: Introductionmentioning

confidence: 97%

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Cell salvage within adult and pediatric idiopathic scoliosis surgery: A random cross-sectional study

Al-Mohrej

Al-Torbaq

Hshem

et al. 2020

SICOT-J

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Introduction: This study aimed to evaluate the use of a cell savage and its impact on the amount of allogenic blood transfused to the patients during idiopathic scoliosis surgery. Methods: A total of 142 randomly selected patients with scoliosis had been included in this study. The adult group consisted of 78 patients, and the pediatric group, 64 patients. Both groups were divided into subgroups (pre-cell saver era and cell saver era). Data on the following parameters were collected: amount of blood transfused intraoperatively, within 24 h postoperatively, and overall. The number of patients who received transfusion was counted as the number of patients who avoided any transfusion. For statistical purposes, we performed unpaired student t-test, chi-square test, and Mann–Whitney test. Results: There was no significant difference in adult groups perioperatively. In the pediatric group, there was a statistically significant difference intraoperatively. Economic analysis of blood management showed positive numbers for both groups, where more than 1 unit of blood was transfused. Conclusions: Statistical analysis showed the cost-effectiveness of the perioperative use of cell salvage during pediatric scoliosis surgery. Overall, the use of cell salvage during scoliosis surgery had a positive impact on both blood management and patient recovery.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 97%

Cell salvage within adult and pediatric idiopathic scoliosis surgery: A random cross-sectional study

Al-Mohrej

Al-Torbaq

Hshem

et al. 2020

SICOT-J

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“…25 In addition, our study was unable to determine any difference in fusion rates, unsurprisingly, as pseudarthrosis rates are reported to be low in AIS deformity correction cases. 26,27 Finally, although the stiffer CoCr rods are expected to have enhanced profile maintenance and rod integrity after correction, previous reports do not support this notion. Work by Serhan et al demonstrated that Ti rods are significantly better at retaining their shape than CoCr or SS rods and are less affected by rod flattening.…”

Section: Discussionmentioning

confidence: 93%

Cobalt-chromium versus titanium alloy rods for correction of adolescent idiopathic scoliosis based on 1-year follow-up: a multicenter randomized controlled clinical trial

Sakai

Tanaka

Takahashi

et al. 2021

Journal of Neurosurgery: Spine

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OBJECTIVE For instrumented correction surgery for adolescent idiopathic scoliosis (AIS), surgeons are increasingly switching from titanium (Ti) alloy rods to stiffer cobalt-chromium (CoCr) rods. The authors conducted the first multicenter randomized controlled clinical trial to investigate whether these materials affect the outcomes in terms of spine correction and quality of life (QOL). This trial was registered at UMIN Clinical Trials Registry on September 3, 2012, under the identifier UMIN000008838 (level of evidence 1). METHODS Female AIS patients (Lenke types 1–3, patient age 10–19 years) were recruited at 5 Japanese institutions and randomized into two cohorts: 6.0-mm-diameter Ti rods were placed in one group, and 6.0-mm-diameter CoCr rods were placed in the other. Patients were followed up at 2 weeks and 3, 6, and 12 months with radiographic examination to quantify the sagittal and coronal correction (Cobb angle, thoracic kyphosis, rib hump, and apical vertebral rotation). Patients completed questionnaires (Scoliosis Research Society–22r, 12-Item Short-Form Health Survey, and Scoliosis Japanese Questionnaire–27) at 6 and 12 months to assess QOL. RESULTS A total of 69 AIS patients were randomized to the demographically similar Ti (n = 37) or CoCr (n = 32) cohort. Four adverse events were recorded, two in each cohort, but these were not related to the rod material. At the final follow-up, both Ti and CoCr cohorts showed significant improvement in spinal correction, including the Cobb angle, thoracic kyphosis, and rib hump size. The correction rates were 68.4% and 67.1% for the Ti and CoCr cohorts, respectively. No parameters differed significantly between the cohorts at any time. Survey data showed improved but similar outcomes in both cohorts. CONCLUSIONS Both treatments (Ti and CoCr) produced similar results and were efficient in engendering clinically significant spine corrections. Clinical trial registration no.: UMIN000008838 (UMIN Clinical Trials Registry)

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“…Although modern instrumentation and new surgical techniques result in good surgical outcomes, the complication rates have remained somewhat constans ranging between 5% and 23% [ 5 , 6 ]. Delayed complications identified on radiogtaphy most commonly include broken rods and pseudarthrosis requiring re-instrumentation [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Unusual cause of hemoptysis: A case report

Fijołek¹,

Oniszh²

2020

Annals of Medicine and Surgery

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Hemoptysis is defined as bleeding from the lower respiratory tract. It can be life-threatening and requires urgent investigation and intervention. Common causes of hemoptysis include bronchiectasis, tuberculosis, aspergilomas and malignancy. We present an unusual case of hemoptysis in a young woman with a history of surgery for scoliosis 18 years earlier. A 30-years-old woman was admitted to our institution for recurring hemoptysis since one year. She had a history of scoliosis and had undergone antero-lateral Th7 through Th12 spinal fusion surgery 18 years earlier. The hemoptysis was slight and resolved spontaneously or after empirical antibiotic therapy, and was attributed to bronchitis. Computed tomography revealed spinal rod penetration into the lung resulting in injury, while the caudal edge of the rod migrated into the liver and the joining screws had entered the mediastinum. Hemoptysis was due to penetration of the rod into the lung. The patient underwent extensive surgery, which was successful. The case highlights the need for thorough evaluation of patients with hemoptysis. Every incident of hemoptysis, even if minor, should be promptly investigated, because it can be life-threatening.

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Surgical treatment of adolescent idiopathic scoliosis: Complications

Cited by 51 publications

References 45 publications

Cell salvage within adult and pediatric idiopathic scoliosis surgery: A random cross-sectional study

Cell salvage within adult and pediatric idiopathic scoliosis surgery: A random cross-sectional study

Cobalt-chromium versus titanium alloy rods for correction of adolescent idiopathic scoliosis based on 1-year follow-up: a multicenter randomized controlled clinical trial

Unusual cause of hemoptysis: A case report

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