Intraoperative Neuromonitoring Auxiliary Significance of DNEP for MEP-positive Event During Severe Spinal Deformity Surgery.

Study Design: This was a retrospective analysis.

Objective: The objective of this study was to assess the intraoperative neuromonitoring auxiliary significance of descending neurogenic-evoked potential (DNEP) for motor-evoked potential (MEP) during severe spinal deformity surgery when MEP-positive event occurs.

Summary Of Background Data: MEP detection is the most widely applied neurological monitoring technique in spinal deformity surgery.

The radiographic, pulmonary, and clinical outcomes of patients with severe rigid spinal deformities treated via halo-pelvic traction.

Background: The severe rigid deformity patients with pulmonary dysfunction could not tolerate complicated corrective surgery. Preoperative traction are used to reduce the curve magnitude and improve the pulmonary function before surgery, including halo-gravity traction (HGT) and halo-pelvic traction (HPT). The present study aimed to retrospectively compare the radiographic, pulmonary and clinical outcomes of preoperative HGT and HPT in severe rigid spinal deformity with respiratory dysfunction.

Risk factors for neurological complications in severe and rigid spinal deformity correction of 177 cases.

Background: Difficult procedures of severe rigid spinal deformity increase the risk of intraoperative neurological injury. Here, we aimed to investigate the preoperative and intraoperative risk factors for postoperative neurological complications when treating severe rigid spinal deformity.

Methods: One hundred seventy-seven consecutive patients who underwent severe rigid spinal deformity correction were assigned into 2 groups: the neurological complication (NC, 22 cases) group or non-NC group (155 cases).

A Retrospective Study of Surgical Correction for Spinal Deformity with and without Osteotomy to Compare Outcome Using Intraoperative Neurophysiological Monitoring with Evoked Potentials.

BACKGROUND This study aimed to evaluate the effects of different combined evoked potentials monitoring modes for non-osteotomy and osteotomy surgery of spinal deformity, and to select individualized modes for various surgeries. MATERIAL AND METHODS We retrospectively reviewed a total of 188 consecutive cases undergoing spinal deformity correction. All patients were classified into 2 cohorts: non-osteotomy (Group A) and osteotomy (Group B).

Gas Embolism After Hydrogen Peroxide Use During Spine Surgery: Case Report and Literature Review.

Background: As an irrigant, an antiseptic, and a hemostatic agent, hydrogen peroxide (HO) is widely used in surgical treatment, but it has been surrounded by persistent controversy. Fatal or near-fatal embolic events caused by HO have been reported sporadically in spine surgery.

Case Description: In this report, we present an 87-year-old man who underwent lumbar instrumentation removal and debridement consequent to surgical site infection in a prone position.

Multimodality Intraoperative Neuromonitoring in Severe Thoracic Deformity Posterior Vertebral Column Resection Correction.

Background: Multimodal intraoperative neuromonitoring (IONM) has been proposed as an effective way to reduce permanent neurologic injury during spinal deformity surgery. However, few studies have reported evoked potential changes at different surgical stages of thoracic posterior vertebral column resection (PVCR).

Methods: A total of 82 cases with severe thoracic deformity (Yang's A type) treated by PVCR in a single institution between January 2010 and March 2015 were reviewed.

Predictive Value of Spinal Cord Function Classification and Sagittal Deformity Angular Ratio for Neurologic Risk Stratification in Patients with Severe and Stiff Kyphoscoliosis.

Background: Three-column osteotomies were developed to treat severe spinal deformities but result in high neurologic complications and require further risk stratification. The present study investigated whether the combination of spinal cord function classification (SCFC) and deformity angular ratio (DAR) could further stratify the neurologic risks in the surgical correction of severe and stiff kyphoscoliosis.

Methods: The patients with kyphoscoliosis who had undergone posterior 3-column osteotomies at the spinal cord level were reviewed.

Surgical Outcome Comparison of Posterior Vertebral Column Resection with or without Anterior Column Support in Treatment of Yang's Type A Severe Thoracic Spinal Deformity.

Background: The use of posterior vertebral column resection (PVCR) has extended the treatment of severe spinal deformity. However, the practice guidelines for anterior column support in patients treated by PVCR remain ill defined. The objective of the present study was to compare the clinical and radiographic outcomes of severe thoracic spinal deformity treated by PVCR with and without anterior column support (ACS).

The Safety and Efficiency of PVCR without Anterior Support Applied in Treatment of Yang Type A Severe Thoracic Kyphoscoliosis.

Objective: To assess the clinical and radiographic outcomes of posterior vertebral column resection (PVCR) without anterior support in treatment of Yang type A severe rigid thoracic kyphoscoliosis.

Methods: The records of 27 Yang type A severe thoracic kyphoscoliosis patients treated with PVCR without anterior support from January 2010 to September 2013 were analyzed retrospectively. Intraoperative multimodal neurophysiological monitoring was conducted in all patients.

Computed Tomography Based Three-dimensional Measurements of Spine Shortening Distance After Posterior Three-column Osteotomies for the Treatment of Severe and Stiff Scoliosis.

Study Design: Retrospective study.

Objectives: This study is to measure and analyze the changes of three-dimensional (3D) distances of spinal column and spinal canal at the three-column osteotomy sites and address their clinical and neurologic significance.

Summary Of Background Data: Three-column osteotomies were developed to treat severe and stiff spine deformities with insufficient understanding on the safe limit of spine shortening and the relationship between the shortening distance of the spinal column and that of the spinal canal.

A proposed classification system for guiding surgical strategy in cases of severe spinal deformity based on spinal cord function.

Purpose: Spinal cord function classification systems are not useful for guiding surgery in patients with severe spinal deformities. The aim of this study is to propose a classification system for determining a surgical strategy that minimizes the risk of neurological dysfunction in patients with severe spinal deformities.

Methods: The records of 89 patients with severe spinal deformities treated with vertebral column reconstruction from 2008 to 2013 were retrospectively analyzed.

Distractional failure forces comparison of different anchor sites for the pediatric growing rod technique.

Purpose: To analyze the distraction load-to-failure force supported by pedicle, lamina or rib linked to different constructs in pediatric cadaveric thoracic spine.

Methods: Eighteen pediatric cadaveric thoracic spines with rib cages were randomly assigned into three testing groups: A (lamina and pedicle), B (rib and pedicle), and C (rib and lamina). Each specimen was sectioned into six units from T1-T2 to T11-T12.