Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis
BackgroundsThe incidence and characteristics of postoperative dysesthesia (POD) have not been reported for posterior vertebral column resection (PVCR) in the treatment of severe spinal kyphoscoliosis.ObjectiveThe objective of the study is to investigate the incidence and characteristics of POD in PV...
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| Language: | English |
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Frontiers Media S.A.
2023-07-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1222520/full |
| _version_ | 1827898483814694912 |
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| author | Hangqin Wu Jie Ding Junlin Yang Wenyuan Sui |
| author_facet | Hangqin Wu Jie Ding Junlin Yang Wenyuan Sui |
| author_sort | Hangqin Wu |
| collection | DOAJ |
| description | BackgroundsThe incidence and characteristics of postoperative dysesthesia (POD) have not been reported for posterior vertebral column resection (PVCR) in the treatment of severe spinal kyphoscoliosis.ObjectiveThe objective of the study is to investigate the incidence and characteristics of POD in PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis.Material and methodsFrom August 2010 to December 2019, 167 patients diagnosed with Yang's type A severe spinal kyphoscoliosis who underwent PVCR without anterior support applied were retrospectively reviewed. All the patients were monitored using five modes of intraoperative multimodal neurophysiological monitoring. Neuromonitoring data, radiographic parameters, and neurological complications were reviewed and analyzed. The incidence and characteristics of POD were further summarized. POD was defined as dysesthetic pain or burning dysesthesia which could be caused by spinal cord kinking or dorsal root ganglion (DRG) injury but with no motor deficits.ResultsPVCR without anterior support was successfully conducted in all 167 patients. Intraoperative monitoring events occurred in five patients. One out of these five patients showed postoperative spinal cord injury (Frankel level C) but completely recovered within 9 months postoperation (Frankel level E). The number of levels and osteotomy space for vertebra resection were 1.28 and 3.6 cm, respectively. POD was confirmed in three patients (3/167, 1.8%), characterized as kyphosis with the apex vertebrae in T12 with the kyphotic Cobb angles of 100°, 115°, and 122°, respectively. The osteotomy space of vertebra resection in these three patients were 3.9, 3.8, and 4.2 cm, respectively. After the treatment by drug administration, they reported pain relief for 12–36 days. The pain gradually moved to the distal end of a proper DRG innervated region near the end.ConclusionsIn this study, the incidence rate of POD in Yang's type A severe spinal kyphoscoliosis patients who underwent PVCR without anterior support applied was 1.8% (3/167). Evoked potential monitoring could not detect the occurrence of POD. POD in Yang's type A severe spinal kyphoscoliosis after PVCR could be ascribed to spinal cord kinking and DRG injury. |
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| format | Article |
| id | doaj.art-86a8f12e1a674182b209b8e33252e73e |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-03-12T23:03:49Z |
| publishDate | 2023-07-01 |
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| series | Frontiers in Surgery |
| spelling | doaj.art-86a8f12e1a674182b209b8e33252e73e2023-07-19T06:45:07ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-07-011010.3389/fsurg.2023.12225201222520Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosisHangqin Wu0Jie Ding1Junlin Yang2Wenyuan Sui3Department of Orthopaedic Surgery, Wuyi County First People's Hospital, Zhejiang, ChinaDepartment of Orthopaedic Surgery, Changxing People's Hospital of Chongming District, Shanghai, ChinaSpine Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaSpine Center, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaBackgroundsThe incidence and characteristics of postoperative dysesthesia (POD) have not been reported for posterior vertebral column resection (PVCR) in the treatment of severe spinal kyphoscoliosis.ObjectiveThe objective of the study is to investigate the incidence and characteristics of POD in PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis.Material and methodsFrom August 2010 to December 2019, 167 patients diagnosed with Yang's type A severe spinal kyphoscoliosis who underwent PVCR without anterior support applied were retrospectively reviewed. All the patients were monitored using five modes of intraoperative multimodal neurophysiological monitoring. Neuromonitoring data, radiographic parameters, and neurological complications were reviewed and analyzed. The incidence and characteristics of POD were further summarized. POD was defined as dysesthetic pain or burning dysesthesia which could be caused by spinal cord kinking or dorsal root ganglion (DRG) injury but with no motor deficits.ResultsPVCR without anterior support was successfully conducted in all 167 patients. Intraoperative monitoring events occurred in five patients. One out of these five patients showed postoperative spinal cord injury (Frankel level C) but completely recovered within 9 months postoperation (Frankel level E). The number of levels and osteotomy space for vertebra resection were 1.28 and 3.6 cm, respectively. POD was confirmed in three patients (3/167, 1.8%), characterized as kyphosis with the apex vertebrae in T12 with the kyphotic Cobb angles of 100°, 115°, and 122°, respectively. The osteotomy space of vertebra resection in these three patients were 3.9, 3.8, and 4.2 cm, respectively. After the treatment by drug administration, they reported pain relief for 12–36 days. The pain gradually moved to the distal end of a proper DRG innervated region near the end.ConclusionsIn this study, the incidence rate of POD in Yang's type A severe spinal kyphoscoliosis patients who underwent PVCR without anterior support applied was 1.8% (3/167). Evoked potential monitoring could not detect the occurrence of POD. POD in Yang's type A severe spinal kyphoscoliosis after PVCR could be ascribed to spinal cord kinking and DRG injury.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1222520/fullpostoperative dysesthesiaposterior vertebral column resectionsevere spinal deformitykyphoscoliosisneurological monitoring |
| spellingShingle | Hangqin Wu Jie Ding Junlin Yang Wenyuan Sui Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis Frontiers in Surgery postoperative dysesthesia posterior vertebral column resection severe spinal deformity kyphoscoliosis neurological monitoring |
| title | Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis |
| title_full | Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis |
| title_fullStr | Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis |
| title_full_unstemmed | Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis |
| title_short | Postoperative dysesthesia after PVCR without anterior support applied in Yang's type A severe spinal kyphoscoliosis |
| title_sort | postoperative dysesthesia after pvcr without anterior support applied in yang s type a severe spinal kyphoscoliosis |
| topic | postoperative dysesthesia posterior vertebral column resection severe spinal deformity kyphoscoliosis neurological monitoring |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1222520/full |
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