Neurosurgery Blog

Icon

Daily bibliographic review of the Neurosurgery Department. La Fe University Hospital. Valencia, Spain

Less Invasive Surgical Correction of Adult Degenerative Scoliosis. Part II: Complications and Clinical Outcome

Neurosurgery 67:1609–1621, 2010 DOI: 10.1227/NEU.0b013e3181f918cf

Surgical correction of adult degenerative scoliosis is a technically demanding procedure with a considerable complication rate. Extensive blood loss has been identified as a significant factor linked to unfavorable outcome.

OBJECTIVE: To report on the complication profile and clinical outcomes obtained with less invasive image-guided surgical correction of degenerative (de novo) scoliosis in a high-risk population.

METHODS: Thirty patients (age, 64-88 years) with progressive postural impairment, back pain, radiculopathy, and neurogenic claudication caused by degenerative scoliosis were treated by less invasive image-guided correction (3-8 segments) by multisegmental transforaminal lumbar interbody fusion and facet fusions. With a mean follow-up of 19.6 months, intraoperative blood loss, curve correction, fusion and complication rates, duration of hospitalization, incidence of hardware-related problems, and clinical outcome parameters were assessed using multivariate analysis.

RESULTS: Satisfactory multiplanar correction was obtained in all patients. Mean intraoperative blood loss was 771.7±231.9 mL, time to full ambulation was 0.8 ± 0.6 days, and length of stay was 8.2 ± 2.9 days. After 12 months, preoperative SF12v2 physical component summary scores (20.2 ± 2.6), visual analog scale scores (7.5 ± 0.8), and Oswestry disability index (57.2 ± 6.9) improved to 34.6 ± 3.9, 2.63 ± 0.6, and 24.8 ± 7.1, respectively. The rate of major and minor complications was 23.4% and 59.9%, respectively. Ninety percent of patients rated treatment success as excellent, good, or fair.

CONCLUSION: Less invasive image-guided correction of degenerative scoliosis in elderly patients with significant comorbidity yields a favorable complication profile. Significant improvements in spinal balance, pain, and functional scores mirrored expedited ambulation and early resumption of daily activities. Less invasive techniques appear suitable to reduce periprocedural morbidity, especially in elderly patients and individuals with significant medical risk factors.

Category: Spine, Surgical technique, Technology

Tagged: , , , , , ,

Comments are closed.

The Safety and Feasibility of Image-Guided BrainPath-Mediated Trans-Sulcal Hematoma Evacuation

Haptic Virtual Reality Aneurysm Clipping

Subtemporal Approach for AICA Aneurysm Clipping

MCA Aneurysm Anatomical Classification Scheme

Blister Aneurysms of the Internal Carotid Artery

Bypass for Complex Basilar Aneurysms

Basilar Invagination and Atlanto-Axial Dislocation Video 1

Indocyanine Green Videoangiography “In Negative” Video 2

Indocyanine Green Videoangiography “In Negative” Video 1

Management of a Recurrent Coiled Giant Posterior Cerebral Artery Aneurysm

Bypass for Complex Basilar Aneurysms

Expanded Endonasal Approach for 2012 MERC

Endoscopic Endonasal Middle Clinoidectomy Video 1

Endoscopic Endonasal Middle Clinoidectomy Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 2

Neurosurgery CNS: Flash Fluorescence for MCA Bypass Video 1

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 2

Neurosurgery CNS: Endoscopic Transventricular Lamina Terminalis Fenestration Video 1

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 2

Neurosurgery CNS: Surgery for Giant PCOM Aneurysms Video 1

NeurosurgeryCNS: Endovascular-Surgical Approach to Cavernous dAVF

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 4

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 3

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 2

Neurosurgery CNS: Lateral Supraorbital Approach Applied to Anterior Clinoidal Meningiomas Video 1

NeurosurgeryCNS: Surgery of AVMs in Motor Areas

NeurosurgeryCNS: The Fenestrated Yaşargil T-Bar Clip

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 3

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 2

NeurosurgeryCNS: Cotton-Clipping Technique to Repair Intraoperative Aneurysm Neck Tear Video 1

NeurosurgeryCNS. ‘Double-Stick Tape’ Technique for Offending Vessel Transposition in Microvascular Decompression

NeurosurgeryCNS: Advances in the Treatment and Outcome of Brain Stem Cavernous Malformation Surgery: 300 Patients

3T MRI Integrated Neuro Suite

NeurosurgeryCNS: 3D In Vivo Modeling of Vestibular Schwannomas and Surrounding Cranial Nerves Using DIT

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 7

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 6

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 5

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 4

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 3

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 2

NeurosurgeryCNS: Microsurgery for Previously Coiled Aneurysms: Experience on 81 Patients: Video 1

NeurosurgeryCNS: Corticotomy Closure Avoids Subdural Collections After Hemispherotomy

NeurosurgeryCNS: Operative Nuances of Side-to-Side in Situ PICA-PICA Bypass Procedure

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 3

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 2

NeurosurgeryCNS. Waterjet Dissection in Neurosurgery: An Update After 208 Procedures: Video 1

NeurosurgeryCNS: Fusiform Aneurysms of the Anterior Communicating Artery

NeurosurgeryCNS. Initial Clinical Experience with a High Definition Exoscope System for Microneurosurgery

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 2

NeurosurgeryCNS: Endoscopic Treatment of Arachnoid Cysts Video 1

NeurosurgeryCNS: Typical colloid cyst at the foramen of Monro.

NeurosurgeryCNS: Neuronavigation for Neuroendoscopic Surgery

NeurosurgeryCNS:New Aneurysm Clip System for Particularly Complex Aneurysm Surgery

NeurosurgeryCNS: AICA/PICA Anatomical Variants Penetrating the Subarcuate Fossa Dura

Craniopharyngioma Supra-Orbital Removal

NeurosurgeryCNS: Use of Flexible Hollow-Core CO2 Laser in Microsurgical Resection of CNS Lesions

NeurosurgeryCNS: Ulnar Nerve Decompression

NeurosurgeryCNS: Microvascular decompression for hemifacial spasm

NeurosurgeryCNS: ICG Videoangiography

NeurosurgeryCNS: Inappropiate aneurysm clip applications


32,977
Unique
Visitors
Powered By Google Analytics

Total views

  • 0
%d bloggers like this: