Comparison of Single-Level Versus Multilevel Vertebral Column Resection Surgery for Pediatric Patients With Severe Spinal Deformities
| Autor: | Chang Ju Hwang, Brenda A. Sides, Kathy M Blanke, Michael P. Kelly, Lawrence G. Lenke |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Decompression Operative Time Severity of Illness Index Neurosurgical Procedures Cohort Studies 03 medical and health sciences 0302 clinical medicine Postoperative Complications Severity of illness medicine Humans Orthopedics and Sports Medicine Child Retrospective Studies 030222 orthopedics business.industry Retrospective cohort study Perioperative Spinal cord Decompression Surgical Spine Surgery medicine.anatomical_structure Treatment Outcome Coronal plane Female Spinal Diseases Neurology (clinical) business 030217 neurology & neurosurgery Vertebral column Cohort study Follow-Up Studies |
| Zdroj: | Spine. 44(11) |
| ISSN: | 1528-1159 |
| Popis: | Study design Retrospective cohort of pediatric patients (younger than 21 years) with severe spinal deformities who underwent vertebral column resection (VCR) surgery. Objective To compare patients who underwent single- versus multilevel VCR surgery in terms of radiographic correction and perioperative complications. Summary of background data There are few studies comparing single- to multilevel VCR surgery regarding the efficacy and safety of the procedures. Methods Eighty-two pediatric patients who underwent a VCR for severe spinal deformity between 2002 and 2012 by one surgeon were included. A single-level VCR was performed in 45 patients with an average of 4.7-year follow-up, and multilevel VCR in 37 patients with an average of 4.6-year follow-up. Results Coronal Cobb corrections were not different between groups (single level: 63%, multilevel: 58%, P = 0.146). Correction loss at final follow-up did not differ (3.1° vs. 0.3°, P = 0.132). Patients in the single-level group had shorter operation times (9.2 vs. 10.5 hours, P = 0.046), whereas estimated blood loss did not differ between the two groups (1061 vs. 1200 mL, P = 0.181). The rate of spinal cord monitoring events was 20% (8/40) and 30% (9/30), respectively. No patient in the single-level group had a postoperative neurologic deficit, whereas three patients in the multilevel group experienced a temporary deficit postoperatively (0/45 vs. 3/37, P = 0.088). Conclusion There was no difference in radiographic correction between the single- and multilevel VCR groups. The multilevel VCR patients had longer operative times, and although the differences were not statistically significant due to low sample size, the multilevel VCR group also had an increased rate of postoperative neurologic deficits. We would recommend single-level VCRs unless there is an absolute indication for multilevel resection as in necessary decompression for spinal cord impingement. Level of evidence 4. |
| Databáze: | OpenAIRE |
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