Articles: spinal-fusion-adverse-effects.
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A meta-analysis. ⋯ In our study, many factors were associated with increased risk of SSI after spinal surgery. We hope this article can provide a reference for spinal surgeons to prevent SSI after spinal surgery.
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To investigate influences of spinopelvic parameters, such as lumbar lordosis (LL) angles, pelvic incidence, sacral slope, pelvic tilt, and sagittal vertical axis, on development of the proximal junctional failure fracture type after posterior instrumentation. ⋯ In our experience, appropriate LL and lower PLK should be obtained at surgery to prevent development of instrumented fracture.
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Previous reports indicated that a decrease in intra-operative cardiac output and mean arterial pressure occurs due to thoracic cage deformities when patients with scoliosis are placed in the prone position. The aims of this study were to investigate the occurrence of hypotension during posterior spinal fusion in adolescent patients with scoliosis, and the association between hypotension, surgical procedures, changes of thoracic cage morphology. This retrospective, single-center, case-control study included 106 patients who underwent surgeries for spinal deformity at our institute between June 2014 and March 2020. ⋯ The T-C and T-B groups had greater sternum deviation parameters than the L-C group, both before and after surgery. All parameters associated with sagittal depth and sternum deviation decreased significantly after surgery in the T-C and the T-B groups. In corrective surgery for constructive thoracic scoliosis, the corrective procedures requiring the application of compression force in the forward direction should be closely monitored in view of their possible influence on circulatory conditions.
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Review Case Reports
Fatal fat embolism syndrome during posterior spinal fusion surgery: A case report and literature review.
Fat embolism syndrome (FES) is a rare but potentially lethal complication. Although serious FES is associated with long bone fractures and major joint surgery, the number of patients who develop fatal FES intraoperatively is probably higher than the described number. We herein report an extremely rare autopsy-confirmed case of fatal FES during posterior spinal fusion to enhance pedicle screw (PS) fixation with allograft bone augmentation. ⋯ Fatal FES associated to seemingly harmless isolated osteoporotic vertebral fractures-vertebroplasty and posterior spinal fusion has been reported. The mechanism was hypothesized to be that both vertebral fractures and spine surgery have the potential to involve bone marrow, thereby increasing intraosseous pressure, and this pressure dislodges fat and bone marrow and pushes them out into the venous circulation, causing systemic inflammation.This is the first report to show histological evidence that the allografted bone embolized to the lungs. Although several reports have indicated that inserting reinforcing materials into the tapped screw holes can enhance the pedicle screw fixation, this procedure may cause severe FES due to fat and debris of material augmentation (i.e. cement, hydroxyapatite, allograft bone). It is important for physicians, especially spinal surgeons, and anesthetists, to be aware of the potential for FES to occur during spinal surgery, which can cause serious complications in a small minority of patients.
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Case Reports
Neurologic deficit due to vertebral body osteophytes after oblique lumbar interbody fusion: A case report.
In recent years, oblique lumbar interbody fusion (OLIF), which uses a window between the peritoneum and the iliopsoas muscle to split the muscle to access the lumbar spine, is known as an effective and safe treatment for spinal diseases, such as degenerative disc disease, spondylolisthesis, recurrent disc herniation, and spinal deformity. Despite this fast and useful surgical method, there were often cases of new neurological symptoms or worsening of symptoms after surgery. We analyzed the preoperative risk factors in a patient with neurologic symptoms, such as motor weakness and exacerbation of radiating pain, after OLIF. ⋯ A prominently protruding osteophyte is assessed as a possible risk factor for the development of new neurologic deficits after OLIF. In patients with confirmed osteophytes, surgery should be planned taking into consideration the shape of the osteophytes and their relationship to the nerve root.