Skip to main content

An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study.

Publication ,  Journal Article
Kato, S; Fehlings, MG; Lewis, SJ; Lenke, LG; Shaffrey, CI; Cheung, KMC; Carreon, LY; Dekutoski, MB; Schwab, FJ; Boachie-Adjei, O; Kebaish, KM ...
Published in: Spine (Phila Pa 1976)
July 1, 2018

STUDY DESIGN: A subanalysis from a prospective, multicenter, international cohort study in 15 sites (Scoli-RISK-1). OBJECTIVE: To report detailed information regarding the severity of neurological decline related to complex adult spine deformity (ASD) surgery and to examine outcomes based on severity. SUMMARY OF BACKGROUND DATA: Postoperative neurological decline after ASD surgeries can occur due to nerve root(s) or spinal cord dysfunction. The impact of decline and the pattern of recovery may be related to the anatomic location and the severity of the injury. METHODS: An investigation of 272 prospectively enrolled complex ASD surgical patients with neurological status measured by American Spinal Injury Association Lower Extremity Motor Scores (LEMS) was undertaken. Postoperative neurological decline was categorized into "major" (≥5 points loss) versus "minor" (<5 points loss) deficits. Timing and extent of recovery in LEMS were investigated for each group. RESULTS: Among the 265 patients with LEMS available at discharge, 61 patients (23%) had neurological decline, with 20 (33%) experiencing major decline. Of note, 90% of the patients with major decline had deficits in three or more myotomes. Full recovery was seen in 24% at 6 weeks and increased to 65% at 6 months. However, 34% continued to experience some neurological decline at 24 months, with 6% demonstrating no improvement. Of 41 patients (67%) with minor decline, 73% had deficits in one or two myotomes. Full recovery was seen in 49% at 6 weeks and increased to 70% at 6 months. Of note, 26% had persistence of some neurological deficit at 24 months, with 18% demonstrating no recovery. CONCLUSION: In patients undergoing complex ASD correction, a rate of postoperative neurological decline of 23% was noted with 33% of these being "major." Although most patients showed substantial recovery by 6 months, approximately one-third continued to experience neurological dysfunction. LEVEL OF EVIDENCE: 2.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

July 1, 2018

Volume

43

Issue

13

Start / End Page

905 / 912

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Scoliosis
  • Risk Factors
  • Prospective Studies
  • Postoperative Complications
  • Orthopedics
  • Nervous System Diseases
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kato, S., Fehlings, M. G., Lewis, S. J., Lenke, L. G., Shaffrey, C. I., Cheung, K. M. C., … Berven, S. H. (2018). An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study. Spine (Phila Pa 1976), 43(13), 905–912. https://doi.org/10.1097/BRS.0000000000002486
Kato, So, Michael G. Fehlings, Stephen J. Lewis, Lawrence G. Lenke, Christopher I. Shaffrey, Kenneth M. C. Cheung, Leah Y. Carreon, et al. “An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study.Spine (Phila Pa 1976) 43, no. 13 (July 1, 2018): 905–12. https://doi.org/10.1097/BRS.0000000000002486.
Kato S, Fehlings MG, Lewis SJ, Lenke LG, Shaffrey CI, Cheung KMC, et al. An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study. Spine (Phila Pa 1976). 2018 Jul 1;43(13):905–12.
Kato, So, et al. “An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study.Spine (Phila Pa 1976), vol. 43, no. 13, July 2018, pp. 905–12. Pubmed, doi:10.1097/BRS.0000000000002486.
Kato S, Fehlings MG, Lewis SJ, Lenke LG, Shaffrey CI, Cheung KMC, Carreon LY, Dekutoski MB, Schwab FJ, Boachie-Adjei O, Kebaish KM, Ames CP, Qiu Y, Matsuyama Y, Dahl BT, Mehdian H, Pellisé F, Berven SH. An Analysis of the Incidence and Outcomes of Major Versus Minor Neurological Decline After Complex Adult Spinal Deformity Surgery: A Subanalysis of Scoli-RISK-1 Study. Spine (Phila Pa 1976). 2018 Jul 1;43(13):905–912.

Published In

Spine (Phila Pa 1976)

DOI

EISSN

1528-1159

Publication Date

July 1, 2018

Volume

43

Issue

13

Start / End Page

905 / 912

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Scoliosis
  • Risk Factors
  • Prospective Studies
  • Postoperative Complications
  • Orthopedics
  • Nervous System Diseases
  • Middle Aged
  • Male