Deformity Angular Ratio Describes the Severity of Spinal Deformity and Predicts the Risk of Neurologic Deficit in Posterior Vertebral Column Resection Surgery
| Autor: | Kathy M Blanke, Michael Roth, Linda A. Koester, Earl Thuet, Lawrence G. Lenke, Xiao-bin Wang |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Kyphosis Scoliosis Severity of Illness Index Neurosurgical Procedures 03 medical and health sciences Young Adult 0302 clinical medicine Evoked Potentials Somatosensory Monitoring Intraoperative parasitic diseases Severity of illness Deformity Medicine Humans Orthopedics and Sports Medicine Child Aged Retrospective Studies 030222 orthopedics business.industry fungi Retrospective cohort study Middle Aged medicine.disease Spinal cord Neurophysiological Monitoring Sagittal plane Spine Surgery Osteotomy medicine.anatomical_structure Child Preschool Female Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Vertebral column |
| Zdroj: | Spine. 41(18) |
| ISSN: | 1528-1159 |
| Popis: | STUDY DESIGN Retrospective review of prospectively collected data. OBJECTIVE To assess the value of the deformity angular ratio (DAR, maximum Cobb measurement divided by number of vertebrae involved) in evaluating the severity of spinal deformity, and predicting the risk of neurologic deficit in posterior vertebral column resection (PVCR). SUMMARY OF BACKGROUND DATA Although the literature has demonstrated that PVCR in spinal deformity patients has achieved excellent outcomes, it is still high risk neurologically. This study, to our knowledge, is the largest series of PVCR patients from a single center, evaluating deformity severity, and potential neurologic deficit risk. METHODS A total of 202 consecutive pediatric and adult patients undergoing PVCRs from November 2002 to September 2014 were reviewed. The DAR (coronal DAR, sagittal DAR, and total DAR) was used to evaluate the complexity of the deformity. RESULTS The incidence of spinal cord monitoring (SCM) events was 20.5%. Eight patients (4.0%) had new neurologic deficits. Patients with a high total DAR (≥25) were significantly younger (20.3 vs. 29.0 yr, P = 0.001), had more severe coronal and sagittal deformities, were more myelopathic (33.3% vs. 11.7%, P = 0.000), needed larger vertebral resections (1.8 vs. 1.3, P = 0.000), and had a significantly higher rate of SCM events than seen in the low total DAR ( |
| Databáze: | OpenAIRE |
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