Ponte Osteotomies Increase the Risk of Neuromonitoring Alerts in Adolescent Idiopathic Scoliosis Correction Surgery

被引:26
作者
Buckland, Aaron J. [1 ]
Moon, John Y. [1 ]
Betz, Randal R. [2 ,3 ]
Lonner, Baron S. [4 ]
Newton, Peter O. [5 ]
Shufflebarger, Harry L. [6 ]
Errico, Thomas J. [1 ]
机构
[1] NYU, Langone Orthoped Hosp, Spine Res Ctr, 301 East 17th St, New York, NY 10003 USA
[2] Inst Spine & Scoliosis, Lawrenceville, NJ USA
[3] St Peters Hosp, New Brunswick, NJ USA
[4] Mt Sinai Hosp, New York, NY 10029 USA
[5] Rady Childrens Hosp, San Diego, CA USA
[6] Nicklaus Childrens Hosp, Miami, FL USA
关键词
adolescent idiopathic scoliosis; coronal balance; deformity correction; Lenke curve classification; neuromonitoring alerts; patient reported outcome measures; Ponte osteotomy; sagittal balance; SURGICAL-TREATMENT; POSTERIOR; OUTCOMES;
D O I
10.1097/BRS.0000000000002784
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Observational cohort study of prospective database registry. Objective. To determine the incidence of neurological complications in AIS patients undergoing surgical treatment with PO. Summary of Background Data. Despite the widespread use of Ponte Osteotomies (PO) in adolescent idiopathic scoliosis (AIS) correction, outcomes and complications in patients treated with this technique have not been well characterized. Methods. A multicenter prospective registry of patients undergoing surgical correction of AIS was queried at 2-year follow-up for patient demographics, surgical data, deformity characteristics, and peri-operative complications. A neurological complication was defined as perioperative nerve root or spinal cord injury as identified by the surgeon. Patients were divided into those who underwent peri-apical PO and those without, and further stratified by Lenke curve classification into 3 groups (Itypes 1 and 2, II-types 3, 4, 6, and III-type 5). Patients with-and without neurological complications were compared with respect to baseline demographics, surgical variables, curve types, fusion construct types (screws vs. hybrid), curve magnitude (coronal and sagittal Cobb), apical vertebral translation, and coronaldeformity angular ratios (C-DAR). Results. Of 2210 patients included in the study, 1611 underwent PO. Peri-operative neurological complications occurred in 7 patients, with 6 in the PO group (0.37%) and 1 in non-PO group (0.17%) though this was not a statistically significant risk factor for peri-operative neurological injury (P = 0.45). Neuromonitoring alerts were recorded in 168 patients (7.6%: 9.3% PO group; 4.2% no-PO group (P < 0.001)). Multivariate logistic regression analysis found PO and curve magnitude to be independent risk factors for intraoperative neuromonitoring alerts (P< 0.01). Conclusion. PO and curve magnitude were independent risk factors for intraoperative neuromonitoring alerts in surgical AIS correction. The effect of Ponte osteotomy on neurological complications remains unknown due to the low incidence of these complications.
引用
收藏
页码:E175 / E180
页数:6
相关论文
共 20 条
[1]  
[Anonymous], 2013, BMJ, DOI DOI 10.1136/BMJ.F2508
[2]   Improving perioperative care for adolescent idiopathic scoliosis patients: the impact of a multidisciplinary care approach [J].
Borden, Timothy C. ;
Bellaire, Laura L. ;
Fletcher, Nicholas D. .
JOURNAL OF MULTIDISCIPLINARY HEALTHCARE, 2016, 9 :435-445
[3]   Surgical treatment of idiopathic adolescent scoliosis [J].
Bridwell, KH .
SPINE, 1999, 24 (24) :2607-2616
[4]   Health-related quality of life in patients with adolescent idiopathic scoliosis: a matched follow-up after treatment with at least 20 years brace or surgery [J].
Danielsson, AJ ;
Wiklund, I ;
Pehrsson, K ;
Nachemson, AL .
EUROPEAN SPINE JOURNAL, 2001, 10 (04) :278-288
[5]   Impact of Multimodal Intraoperative Monitoring During Surgery for Spine Deformity and Potential Risk Factors for Neurological Monitoring Changes [J].
Feng, Bin ;
Qiu, Guixing ;
Shen, Jianxiong ;
Zhang, Jianguo ;
Tian, Ye ;
Li, Shugang ;
Zhao, Hong ;
Zhao, Yu .
JOURNAL OF SPINAL DISORDERS & TECHNIQUES, 2012, 25 (04) :E108-E114
[6]   The Ponte procedure - Posterior only treatment of Scheuermann's kyphosis using segmental posterior shortening and pedicle screw instrumentation [J].
Geck, Matthew J. ;
Macagno, Angel ;
Ponte, Alberto ;
Shufflebarger, Harry L. .
JOURNAL OF SPINAL DISORDERS & TECHNIQUES, 2007, 20 (08) :586-593
[7]   Do Multilevel Ponte Osteotomies in Thoracic Idiopathic Scoliosis Surgery Improve Curve Correction and Restore Thoracic Kyphosis? [J].
Halanski, Matthew Aaron ;
Cassidy, Jeffrey A. .
JOURNAL OF SPINAL DISORDERS & TECHNIQUES, 2013, 26 (05) :252-255
[8]   Rates of New Neurological Deficit Associated With Spine Surgery Based on 108,419 Procedures [J].
Hamilton, D. Kojo ;
Smith, Justin S. ;
Sansur, Charles A. ;
Glassman, Steven D. ;
Ames, Christopher P. ;
Berven, Sigurd H. ;
Polly, David W., Jr. ;
Perra, Joseph H. ;
Knapp, Dennis Raymond ;
Boachie-Adjei, Oheneba ;
McCarthy, Richard E. ;
Shaffrey, Christopher I. .
SPINE, 2011, 36 (15) :1218-1228
[9]   Multisurgeon assessment of surgical decision-making in adolescent idiopathic scoliosis - Curve classification, operative approach, and fusion levels [J].
Lenke, LG ;
Betz, RR ;
Haher, TR ;
Lapp, MA ;
Merola, AA ;
Harms, J ;
Shufflebarger, HL .
SPINE, 2001, 26 (21) :2347-2353
[10]  
Louie PK, 2017, SEMIN SPINE SURG, V27, P222