Study Design: Multicenter retrospective case series.
Objective: To report the risks, recovery, and clinical impact of neurological complications (NCs) in adult spinal deformity (ASD) surgery.
Summary Of Background Data: Although recent studies have reported the incidence of NCs in ASD surgery, few have addressed the recovery from and clinical impacts of NC.
Methods: We reviewed records from a multicenter database for 285 consecutive surgically treated ASD patients who had reached a 2-year follow-up. NCs were categorized as sensory only or motor deficit (MD). Recovery was noted as none, partial, or complete, during hospitalization and at every postoperation visit. Uni- and multivariate risk analyses were performed to identify risk factors for MD.
Results: NC developed in 29 (10%) patients within 30 days of surgery, of which 11 were permanent deficits (seven no recovery, and four partial recovery). MD developed in 14 (5%) patients, including one spinal cord injury. Seven MD patients required physical assistance at the latest follow-up. While NC patients experienced significant improvements in health-related quality of life at the 2-year follow-up, the health-related quality of life was significantly worse for the NC versus no-NC group at this time point. Univariate analyses revealed that Schwab-SRS types N and L, pelvic tilt, modified frailty index physical function, and an inferior SRS22 function domain at baseline were risk factors for MD. Among them, modified frailty index physical function, which represented a preoperative decline in activities of daily living, was identified as an independent risk factor for MD (OR: 4.0, 95% CI: 1.2-13.5, P = 0.03).
Conclusions: NC developed in 10% of ASD surgery patients, with permanent deficits occurring in 4%. Half of the patients who developed MD required physical assistance, which contributed to the inferior clinical outcomes. Surgical intervention should be considered before severe activities of daily living decline to prevent NCs.
Level Of Evidence: 4.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BRS.0000000000003080 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Background: A 73-year-old female with a 3 year history of Alzheimer's disease was treated within the protocol of The Alzheimer's Autism and Cognitive Impairment Stem Cell Treatment Study (ACIST), an IRB approved clinical study registered with clinicaltrials.gov NCT03724136.
Method: The procedure consists of bone marrow aspiration, cell separation using an FDA cleared class 2 device, and intravenous and intranasal administration of the stem cell fraction.
Presence of Fragmented Intratumoral Thrombosed Microvasculature in the Necrotic and Peri-Necrotic Regions on SWI Differentiates IDH Wild-Type Glioblastoma From IDH Mutant Grade 4 Astrocytoma.
J Magn Reson Imaging
January 2025
Department of Radiology, Fortis Memorial Research Institute, Gurugram, India.
Background: Isocitrate dehydrogenase (IDH) wild-type (IDH) glioblastomas (GB) are more aggressive and have a poorer prognosis than IDH mutant (IDH) tumors, emphasizing the need for accurate preoperative differentiation. However, a distinct imaging biomarker for differentiation mostly lacking. Intratumoral thrombosis has been reported as a histopathological biomarker for GB.
View Article and Find Full Text PDFPrecision Opioid Prescription in ICU Surgery: Insights from an Interpretable Deep Learning Framework.
J Surg (Lisle)
November 2024
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Purpose: Appropriate opioid management is crucial to reduce opioid overdose risk for ICU surgical patients, which can lead to severe complications. Accurately predicting postoperative opioid needs and understanding the associated factors can effectively guide appropriate opioid use, significantly enhancing patient safety and recovery outcomes. Although machine learning models can accurately predict postoperative opioid needs, lacking interpretability hinders their adoption in clinical practice.
View Article and Find Full Text PDFQuantifying the potential contribution of drugs to the occurrence of acute kidney injury in patients with chronic kidney disease.
Clin Kidney J
January 2025
Pharmacoepidemiology Unit, Department of Clinical Pharmacology, Amiens-Picardie University Medical Center, Amiens, France.
Background: We sought to comprehensively describe drug-related components associated with acute kidney injury (AKI) in patients with chronic kidney disease (CKD), describing the incidence of drug-related AKI, the proportion of preventable AKI, identified the various drugs potentially associated with it, explored the risk factors, and assessed the 1-year incidences of the recurrence of drug-related AKI, kidney failure, and death.
Methods: CKD-REIN is a French national prospective cohort of 3033 nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 ml/min/1.73 m²).
Efficacy and Safety of Ciprofol for Anesthesia in Painless Colonoscopy with Varying Body Mass Indices Patients: A Prospective, Single-Center, Observational Study.
Drug Des Devel Ther
January 2025
Department of Anesthesiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, 330006, People's Republic of China.
Background: Ciprofol, a novel intravenous anesthetic derived from propofol, exhibits high lipophilicity. Its pharmacokinetics and pharmacodynamics may vary across different body mass indices (BMI) categories, but data on its optimal dosing as well as its safety and efficacy during colonoscopy anesthesia in varying BMI groups are lacking.
Objective: To evaluate the efficacy and safety of ciprofol during anesthesia for painless colonoscopy in patients with varying BMI, and to explore the correlation between BMI and induction dose.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!