| Autor: |
Van Halm-Lutterodt, Nicholas Ishmael, Al-Saidi, Neil Nazar, Mandalia, Krishna, Mesregah, Mohamed Kamal, Ghanem, Kristina Marie, Storlie, Nicholas Robert, Huang, Wei-Hsun, Chen, Wei-Cheng, Bartels-Mensah, Mercy, Chen, Xin Yuan, Ye, Ziyang, Zhang, Yangpu, Pan, Aixing, Kim, Sunny Sik, Lonner, Baron, Alanay, Ahmet, Hai, Yong |
| Předmět: |
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| Zdroj: |
Global Spine Journal; Jul2023, Vol. 13 Issue 6, p1646-1657, 12p |
| Abstrakt: |
Study Design: Systematic review and meta-analysis. Objective: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes between those classified osteotomy approaches. Methods: Thorough literature review and meta-analysis were conducted between January 2000 and September 2021. The selection criteria were studies: i) reporting major curve Cobb angle of ≥80° and flexibility of <25% or 30%; ii) comparing VCR or ≥ Type V Schwab osteotomy defined as VCR-based vs [non-VCR-based] techniques, (any osteotomy or technique other than VCR); iii) published in English with ≥10 patients; iv) reporting complication rates; and v) having minimum of 2-year follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Significance level was set at (P <.05). Results: Of the 174 patients included, 52.30% (n = 91) and 47.70% (n = 83) were VCR-based and non-VCR-based, respectively. The incidence of dural tears/nerve injuries/significant intraoperative-neuromonitoring changes was significantly higher; [OR = 6.78, CI= (1.75 to 26.17), I2 = 0%, (P =.006)] in the VCR-based group than the non-VCR-based group. The 'overall surgical and medical' complication rate was significantly higher in the VCR-based group, [OR = 1.94, CI= (1.02 to 3.67), I2 = 31%, (P =.04)]. Conclusion: Both VCR-based and non-VCR-based surgical techniques for management of severe rigid scoliosis and kyphoscoliosis patients pose comparable overall surgical complication rates, while a significantly higher perioperative neurological complication incidence was associated with VCR-based technique compared to the non-VCR-based techniques. The VCR-based technique was associated with 6.78 times higher incidence of neurological complications compared to non-VCR-based techniques. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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