Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis
Introduction: Patients with neuromuscular disorders sometimes show progressive spinal scoliosis. The surgery for neuromuscular scoliosis (NMS) has high rates of complications. In this study, we elucidated the perioperative complications in patients with NMS. Methods: We included 83 patients with NMS...
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Japanese Society for Spine Surgery and Related Research
2018-10-01
|
| Series: | Spine Surgery and Related Research |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0075/_pdf/-char/en |
| _version_ | 1818672515532193792 |
|---|---|
| author | Mitsuyoshi Matsumoto Masayuki Miyagi Wataru Saito Takayuki Imura Gen Inoue Toshiyuki Nakazawa Eiki Shirasawa Kentaro Uchida Tsutomu Akazawa Naonobu Takahira Masashi Takaso |
| author_facet | Mitsuyoshi Matsumoto Masayuki Miyagi Wataru Saito Takayuki Imura Gen Inoue Toshiyuki Nakazawa Eiki Shirasawa Kentaro Uchida Tsutomu Akazawa Naonobu Takahira Masashi Takaso |
| author_sort | Mitsuyoshi Matsumoto |
| collection | DOAJ |
| description | Introduction: Patients with neuromuscular disorders sometimes show progressive spinal scoliosis. The surgery for neuromuscular scoliosis (NMS) has high rates of complications. In this study, we elucidated the perioperative complications in patients with NMS.
Methods: We included 83 patients with NMS (58 boys and 25 girls; 61 with muscular dystrophy, 18 with spinal muscular atrophy, and 4 others) who had undergone posterior fusion surgery for scoliosis. We evaluated the perioperative complications (within 3 months), age at time of surgery, operative time, blood loss, preoperative %VC and FEV1.0 (%) for pulmonary function, and preoperative ejection fraction (EF) for cardiac function.
Results: There were 5 (6%) major complications, including pneumonia and a cardiovascular complication requiring intensive care unit (ICU) care, and 15 (18%) minor complications including viral enteritis and a urinary tract infection. Overall, there were 20 (24%) complications. Three of the 5 major complications were pulmonary. The mean age at the time of surgery was 13.7 y, operative time was 304 min, and blood loss was 1530 ml. The mean preoperative %VC was 41%, FEV1.0 was 91%, and EF was 60%. When we separated the patients into a group with major complications (n = 5) and a group without major complications (n = 78), the preoperative %VC in the group with major complications (23%) was significantly lower than that in the group without (42%) (p < 0.05). However, operative time, blood loss, preoperative FEV1.0 (%) and EF between the two groups were not significantly different (p > 0.05).
Conclusions: Compared with the previous findings of the perioperative complication rate (45%-74%) for NMS, the complication rate was remarkably low in this case series. Because of advances in medical skills, including anesthesia and surgical instruments, surgery for NMS appears to be safe. However, patients with NMS with complications demonstrated severe restrictive ventilatory impairment preoperatively. Therefore, we should be vigilant for perioperative pulmonary complications especially in patients with NMS and preoperative severe restrictive ventilatory impairment. |
| first_indexed | 2024-12-17T07:41:07Z |
| format | Article |
| id | doaj.art-5cb73e8e6481408386c616831792e265 |
| institution | Directory Open Access Journal |
| issn | 2432-261X |
| language | English |
| last_indexed | 2024-12-17T07:41:07Z |
| publishDate | 2018-10-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj.art-5cb73e8e6481408386c616831792e2652022-12-21T21:58:08ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2018-10-012427828210.22603/ssrr.2017-00752017-0075Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular ScoliosisMitsuyoshi Matsumoto0Masayuki Miyagi1Wataru Saito2Takayuki Imura3Gen Inoue4Toshiyuki Nakazawa5Eiki Shirasawa6Kentaro Uchida7Tsutomu Akazawa8Naonobu Takahira9Masashi Takaso10Department of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, St. Marianna University School of MedicineDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityDepartment of Orthopaedic Surgery, School of Medicine, Kitasato UniversityIntroduction: Patients with neuromuscular disorders sometimes show progressive spinal scoliosis. The surgery for neuromuscular scoliosis (NMS) has high rates of complications. In this study, we elucidated the perioperative complications in patients with NMS. Methods: We included 83 patients with NMS (58 boys and 25 girls; 61 with muscular dystrophy, 18 with spinal muscular atrophy, and 4 others) who had undergone posterior fusion surgery for scoliosis. We evaluated the perioperative complications (within 3 months), age at time of surgery, operative time, blood loss, preoperative %VC and FEV1.0 (%) for pulmonary function, and preoperative ejection fraction (EF) for cardiac function. Results: There were 5 (6%) major complications, including pneumonia and a cardiovascular complication requiring intensive care unit (ICU) care, and 15 (18%) minor complications including viral enteritis and a urinary tract infection. Overall, there were 20 (24%) complications. Three of the 5 major complications were pulmonary. The mean age at the time of surgery was 13.7 y, operative time was 304 min, and blood loss was 1530 ml. The mean preoperative %VC was 41%, FEV1.0 was 91%, and EF was 60%. When we separated the patients into a group with major complications (n = 5) and a group without major complications (n = 78), the preoperative %VC in the group with major complications (23%) was significantly lower than that in the group without (42%) (p < 0.05). However, operative time, blood loss, preoperative FEV1.0 (%) and EF between the two groups were not significantly different (p > 0.05). Conclusions: Compared with the previous findings of the perioperative complication rate (45%-74%) for NMS, the complication rate was remarkably low in this case series. Because of advances in medical skills, including anesthesia and surgical instruments, surgery for NMS appears to be safe. However, patients with NMS with complications demonstrated severe restrictive ventilatory impairment preoperatively. Therefore, we should be vigilant for perioperative pulmonary complications especially in patients with NMS and preoperative severe restrictive ventilatory impairment.https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0075/_pdf/-char/enNeuromuscular scoliosisperioperative complicationsposterior spinal fusion surgery |
| spellingShingle | Mitsuyoshi Matsumoto Masayuki Miyagi Wataru Saito Takayuki Imura Gen Inoue Toshiyuki Nakazawa Eiki Shirasawa Kentaro Uchida Tsutomu Akazawa Naonobu Takahira Masashi Takaso Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis Spine Surgery and Related Research Neuromuscular scoliosis perioperative complications posterior spinal fusion surgery |
| title | Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis |
| title_full | Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis |
| title_fullStr | Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis |
| title_full_unstemmed | Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis |
| title_short | Perioperative Complications in Posterior Spinal Fusion Surgery for Neuromuscular Scoliosis |
| title_sort | perioperative complications in posterior spinal fusion surgery for neuromuscular scoliosis |
| topic | Neuromuscular scoliosis perioperative complications posterior spinal fusion surgery |
| url | https://www.jstage.jst.go.jp/article/ssrr/2/4/2_2017-0075/_pdf/-char/en |
| work_keys_str_mv | AT mitsuyoshimatsumoto perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT masayukimiyagi perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT watarusaito perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT takayukiimura perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT geninoue perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT toshiyukinakazawa perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT eikishirasawa perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT kentarouchida perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT tsutomuakazawa perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT naonobutakahira perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis AT masashitakaso perioperativecomplicationsinposteriorspinalfusionsurgeryforneuromuscularscoliosis |