The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities
Purpose To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery. Methods A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and...
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| Veröffentlicht in: | European spine journal 2014-01, Vol.23 (1), p.149-156 |
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| creator | Xie, Jing-Ming Zhang, Ying Wang, Ying-Song Bi, Ni Zhao, Zhi Li, Tao Yang, Hua |
| description | Purpose
To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery.
Methods
A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and July 2011 were included in our study. Of the 76 patients, 37 were male and 39 female, with an average age of 17.5 years (range 10–48 years). There were 52 adolescent patients (with an age |
| doi_str_mv | 10.1007/s00586-013-2793-6 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3897813</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3187112861</sourcerecordid><originalsourceid>FETCH-LOGICAL-c503t-a721b36ecd807aa36152a73f0f371dffe7c3edba259b26b618b5d44b4877d0943</originalsourceid><addsrcrecordid>eNqNks2KFTEQhYMoznX0AdxIwI2b1vx0J52NIIN_MOBmXId0utI3Y3fSJukZfApf2dy54zAKgqtA6qtTp4qD0HNKXlNC5JtMSNeLhlDeMKl4Ix6gHW05a4ji7CHaEdWSRkiqTtCTnC8JoZ0i4jE6YVxQJSXdoZ8Xe8DJ52_YGVtiyjg6HGBLcY6Tt3gE560vN98xQJOLmQCvMRdIPiZ8BanAkMyMbZy3JeAEGWzxMWBXy6spHkJtv_ZljzNUHLAJYx05-RHn1YfaWofEtPiK5qfokTNzhme37yn6-uH9xdmn5vzLx89n784b2xFeGiMZHbgAO_ZEGlPX6ZiR3BHHJR2dA2k5jINhnRqYGATth25s26HtpRzrWfgpenvUXbdhgdFWk3UJvSa_mPRDR-P1n5Xg93qKV5r3SvaUV4FXtwIpft8gF734bGGeTYC4ZU1bJXrFebX7HygTsm3pwdbLv9DLuKV6oxuK9H0lD4L0SNkUc07g7nxTog_J0Mdk6JoMfUiGFrXnxf2F7zp-R6EC7AjkWgoTpHuj_6n6CxNJx24</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1490889260</pqid></control><display><type>article</type><title>The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities</title><source>MEDLINE</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>SpringerLink Journals - AutoHoldings</source><creator>Xie, Jing-Ming ; Zhang, Ying ; Wang, Ying-Song ; Bi, Ni ; Zhao, Zhi ; Li, Tao ; Yang, Hua</creator><creatorcontrib>Xie, Jing-Ming ; Zhang, Ying ; Wang, Ying-Song ; Bi, Ni ; Zhao, Zhi ; Li, Tao ; Yang, Hua</creatorcontrib><description>Purpose
To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery.
Methods
A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and July 2011 were included in our study. Of the 76 patients, 37 were male and 39 female, with an average age of 17.5 years (range 10–48 years). There were 52 adolescent patients (with an age <18 years) and 24 adult patients (with an age ≥18 years). Preoperatively, postoperatively and 6 months after surgery, we performed systemically neurologic function evaluations of each patients through meticulous physical examination. Any new abnormality or deterioration in evaluation of neurologic function than preoperative is reckoned postoperative neurologic deficits. Ten variables that might affect the safety of neurologic deficits during PVCR procedures, including imaging factors, clinical factors and operational factors, were analyzed using univariate analysis. Then the variables with statistical difference were analyzed by using multi-factor unconditional logistic regression analysis.
Results
No patient in this series had permanent paraplegia and nerve root injury due to operation. Change of neurologic status was found in six patients after surgery. Results of single-factor comparison demonstrated that the following seven variables were statistically different (
P
< 0.05): location of apex at main curve (
X
3
), Cobb angle at the main curve at the coronal plane (
X
4
), scoliosis associated with thoracic hyperkyphosis (
X
5
), level of vertebral column resected (
X
6
), number of segmental vessels ligated (
X
7
), preexisting neurologic dysfunction (
X
8
), and associated with intraspinal and brain stem anomalies (
X
9
). The multi-factor unconditional logistic regression analysis revealed that
X
8
(OR = 49.322),
X
9
(OR = 18.423),
X
5
(OR = 11.883), and
X
6
(OR = 8.769) were independent and positively correlated with the neurologic deficit.
Conclusions
Preexisting neurologic dysfunction, associated with intraspinal and brain stem anomalies, scoliosis associated with thoracic hyperkyphosis and level of vertebral column resected are independent risk factors for neurologic deficits during PVCR procedure.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-013-2793-6</identifier><identifier>PMID: 23619771</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescence ; Adolescent ; Adult ; Child ; Female ; Humans ; Kyphosis - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Nervous System Diseases - epidemiology ; Nervous System Diseases - etiology ; Neurosurgery ; Original ; Original Article ; Orthopedic Procedures - adverse effects ; Retrospective Studies ; Risk Factors ; Scoliosis - surgery ; Spine - surgery ; Surgical Orthopedics ; Young Adult</subject><ispartof>European spine journal, 2014-01, Vol.23 (1), p.149-156</ispartof><rights>Springer-Verlag Berlin Heidelberg 2013</rights><rights>Springer-Verlag Berlin Heidelberg 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-a721b36ecd807aa36152a73f0f371dffe7c3edba259b26b618b5d44b4877d0943</citedby><cites>FETCH-LOGICAL-c503t-a721b36ecd807aa36152a73f0f371dffe7c3edba259b26b618b5d44b4877d0943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897813/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3897813/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23619771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xie, Jing-Ming</creatorcontrib><creatorcontrib>Zhang, Ying</creatorcontrib><creatorcontrib>Wang, Ying-Song</creatorcontrib><creatorcontrib>Bi, Ni</creatorcontrib><creatorcontrib>Zhao, Zhi</creatorcontrib><creatorcontrib>Li, Tao</creatorcontrib><creatorcontrib>Yang, Hua</creatorcontrib><title>The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery.
Methods
A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and July 2011 were included in our study. Of the 76 patients, 37 were male and 39 female, with an average age of 17.5 years (range 10–48 years). There were 52 adolescent patients (with an age <18 years) and 24 adult patients (with an age ≥18 years). Preoperatively, postoperatively and 6 months after surgery, we performed systemically neurologic function evaluations of each patients through meticulous physical examination. Any new abnormality or deterioration in evaluation of neurologic function than preoperative is reckoned postoperative neurologic deficits. Ten variables that might affect the safety of neurologic deficits during PVCR procedures, including imaging factors, clinical factors and operational factors, were analyzed using univariate analysis. Then the variables with statistical difference were analyzed by using multi-factor unconditional logistic regression analysis.
Results
No patient in this series had permanent paraplegia and nerve root injury due to operation. Change of neurologic status was found in six patients after surgery. Results of single-factor comparison demonstrated that the following seven variables were statistically different (
P
< 0.05): location of apex at main curve (
X
3
), Cobb angle at the main curve at the coronal plane (
X
4
), scoliosis associated with thoracic hyperkyphosis (
X
5
), level of vertebral column resected (
X
6
), number of segmental vessels ligated (
X
7
), preexisting neurologic dysfunction (
X
8
), and associated with intraspinal and brain stem anomalies (
X
9
). The multi-factor unconditional logistic regression analysis revealed that
X
8
(OR = 49.322),
X
9
(OR = 18.423),
X
5
(OR = 11.883), and
X
6
(OR = 8.769) were independent and positively correlated with the neurologic deficit.
Conclusions
Preexisting neurologic dysfunction, associated with intraspinal and brain stem anomalies, scoliosis associated with thoracic hyperkyphosis and level of vertebral column resected are independent risk factors for neurologic deficits during PVCR procedure.</description><subject>Adolescence</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Female</subject><subject>Humans</subject><subject>Kyphosis - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Nervous System Diseases - epidemiology</subject><subject>Nervous System Diseases - etiology</subject><subject>Neurosurgery</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedic Procedures - adverse effects</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Scoliosis - surgery</subject><subject>Spine - surgery</subject><subject>Surgical Orthopedics</subject><subject>Young Adult</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNks2KFTEQhYMoznX0AdxIwI2b1vx0J52NIIN_MOBmXId0utI3Y3fSJukZfApf2dy54zAKgqtA6qtTp4qD0HNKXlNC5JtMSNeLhlDeMKl4Ix6gHW05a4ji7CHaEdWSRkiqTtCTnC8JoZ0i4jE6YVxQJSXdoZ8Xe8DJ52_YGVtiyjg6HGBLcY6Tt3gE560vN98xQJOLmQCvMRdIPiZ8BanAkMyMbZy3JeAEGWzxMWBXy6spHkJtv_ZljzNUHLAJYx05-RHn1YfaWofEtPiK5qfokTNzhme37yn6-uH9xdmn5vzLx89n784b2xFeGiMZHbgAO_ZEGlPX6ZiR3BHHJR2dA2k5jINhnRqYGATth25s26HtpRzrWfgpenvUXbdhgdFWk3UJvSa_mPRDR-P1n5Xg93qKV5r3SvaUV4FXtwIpft8gF734bGGeTYC4ZU1bJXrFebX7HygTsm3pwdbLv9DLuKV6oxuK9H0lD4L0SNkUc07g7nxTog_J0Mdk6JoMfUiGFrXnxf2F7zp-R6EC7AjkWgoTpHuj_6n6CxNJx24</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Xie, Jing-Ming</creator><creator>Zhang, Ying</creator><creator>Wang, Ying-Song</creator><creator>Bi, Ni</creator><creator>Zhao, Zhi</creator><creator>Li, Tao</creator><creator>Yang, Hua</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140101</creationdate><title>The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities</title><author>Xie, Jing-Ming ; Zhang, Ying ; Wang, Ying-Song ; Bi, Ni ; Zhao, Zhi ; Li, Tao ; Yang, Hua</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-a721b36ecd807aa36152a73f0f371dffe7c3edba259b26b618b5d44b4877d0943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescence</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Female</topic><topic>Humans</topic><topic>Kyphosis - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Nervous System Diseases - epidemiology</topic><topic>Nervous System Diseases - etiology</topic><topic>Neurosurgery</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedic Procedures - adverse effects</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Scoliosis - surgery</topic><topic>Spine - surgery</topic><topic>Surgical Orthopedics</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xie, Jing-Ming</creatorcontrib><creatorcontrib>Zhang, Ying</creatorcontrib><creatorcontrib>Wang, Ying-Song</creatorcontrib><creatorcontrib>Bi, Ni</creatorcontrib><creatorcontrib>Zhao, Zhi</creatorcontrib><creatorcontrib>Li, Tao</creatorcontrib><creatorcontrib>Yang, Hua</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xie, Jing-Ming</au><au>Zhang, Ying</au><au>Wang, Ying-Song</au><au>Bi, Ni</au><au>Zhao, Zhi</au><au>Li, Tao</au><au>Yang, Hua</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>23</volume><issue>1</issue><spage>149</spage><epage>156</epage><pages>149-156</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
To determine the risk factors of neurologic deficits during PVCR correction, so as to help improve safety during and after surgery.
Methods
A consecutive series of 76 patients with severe and rigid spinal deformities who were treated with PVCR at a single institution between October 2004 and July 2011 were included in our study. Of the 76 patients, 37 were male and 39 female, with an average age of 17.5 years (range 10–48 years). There were 52 adolescent patients (with an age <18 years) and 24 adult patients (with an age ≥18 years). Preoperatively, postoperatively and 6 months after surgery, we performed systemically neurologic function evaluations of each patients through meticulous physical examination. Any new abnormality or deterioration in evaluation of neurologic function than preoperative is reckoned postoperative neurologic deficits. Ten variables that might affect the safety of neurologic deficits during PVCR procedures, including imaging factors, clinical factors and operational factors, were analyzed using univariate analysis. Then the variables with statistical difference were analyzed by using multi-factor unconditional logistic regression analysis.
Results
No patient in this series had permanent paraplegia and nerve root injury due to operation. Change of neurologic status was found in six patients after surgery. Results of single-factor comparison demonstrated that the following seven variables were statistically different (
P
< 0.05): location of apex at main curve (
X
3
), Cobb angle at the main curve at the coronal plane (
X
4
), scoliosis associated with thoracic hyperkyphosis (
X
5
), level of vertebral column resected (
X
6
), number of segmental vessels ligated (
X
7
), preexisting neurologic dysfunction (
X
8
), and associated with intraspinal and brain stem anomalies (
X
9
). The multi-factor unconditional logistic regression analysis revealed that
X
8
(OR = 49.322),
X
9
(OR = 18.423),
X
5
(OR = 11.883), and
X
6
(OR = 8.769) were independent and positively correlated with the neurologic deficit.
Conclusions
Preexisting neurologic dysfunction, associated with intraspinal and brain stem anomalies, scoliosis associated with thoracic hyperkyphosis and level of vertebral column resected are independent risk factors for neurologic deficits during PVCR procedure.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>23619771</pmid><doi>10.1007/s00586-013-2793-6</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Adolescence Adolescent Adult Child Female Humans Kyphosis - surgery Male Medicine Medicine & Public Health Middle Aged Nervous System Diseases - epidemiology Nervous System Diseases - etiology Neurosurgery Original Original Article Orthopedic Procedures - adverse effects Retrospective Studies Risk Factors Scoliosis - surgery Spine - surgery Surgical Orthopedics Young Adult |
| title | The risk factors of neurologic deficits of one-stage posterior vertebral column resection for patients with severe and rigid spinal deformities |
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