Spine
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Thirty-seven patients who experienced visual loss after spine surgery were identified through a survey of the members of the Scoliosis Research Society and a review of the recent literature. ⋯ The authors conclude that blindness after spine surgery is more common than has been recognized previously. Most cases are associated with complex instrumented fusions.
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Using compound muscle action potentials after train spinal stimulation, intraoperative motor functional monitoring was performed during thoracic and thoracolumbar spinal surgery. ⋯ The success rate in obtaining muscle potentials was greatly enhanced when all of the following methods were used: train spinal stimulation, anesthetic with weak suppressive effect, multiple muscle recording, and percutaneous introduction of epidural electrode. The critical point of compound muscle action potential change should be defined as a 10% latency delay or disappearance. Multisegmental muscle potential after train spinal stimulation is the most appropriate method for thoracic and thoracolumbar spinal surgery.
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Analysis of the clinical results of 20 patients with thoracic scoliosis treated by anterior procedure with Kaneda anterior spinal system. ⋯ Anterior correction with Kaneda anterior spinal system provides excellent correction of the frontal curvature and sagittal alignment by fusing within the range of the major curve, without a significant loss of correction and implant failure. Rigid rotational deformity of the thoracic scoliosis is effectively corrected by resection of the rib head joints and rod rotation maneuver. However, too much correction of the thoracic curve should be avoided, to prevent decompensation of the lumbar curve, especially in Type II curves.
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A retrospective review of 3450 spinal surgeries was performed. ⋯ The risk of ophthalmic complications with spinal surgery has not been fully appreciated. Because ophthalmic complications in spinal surgery may be reversed with prompt recognition and intervention, it is important for clinicians to be aware of their possible occurrence.
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A retrospective assessment of the effectiveness of lumbar pedicle screws versus laminar hooks in lumbar curve correction with double major curves in adolescent idiopathic scoliosis. ⋯ Lumbar pedicle screws may offer greater lumbar curve correction, better maintenance of correction, and greater correction of the uninstrumented spine below double major curves. No complications were associated with the placement of pedicle screws.