Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Unilateral versus bilateral lower extremity motor deficit following complex adult spinal deformity surgery: is there a difference in recovery up to 2 year Follow Up?

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Lumbar spinal stenosis: comparison of surgical practice variation and clinical outcome in three national spine registries

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Outcomes following discectomy for lumbar disc herniation in patients with substantial back pain

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  3. Outcomes of decompression without fusion in patients with lumbar spinal stenosis with back pain

    Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

  1. Evaluation of a new sagittal classification system in adolescent idiopathic scoliosis

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Use of Opioids and Other Analgesics Before and After Primary Surgery for Adult Spinal Deformity: A 10-Year Nationwide Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  • Alexander Tuchman
  • Lawrence G Lenke
  • Meghan Cerpa
  • Michael G Fehlings
  • Stephen J Lewis
  • Christopher I Shaffrey
  • Kenneth M C Cheung
  • Leah Yacat Carreon
  • Mark B Dekutoski
  • Frank J Schwab
  • Oheneba Boachie-Adjei
  • Khaled Kebaish
  • Christopher P Ames
  • Yong Qiu
  • Yukihiro Matsuyama
  • Benny T Dahl
  • Hossein Mehdian
  • Ferran Pellisé
  • Sigurd H Berven
Vis graf over relationer

BACKGROUND CONTEXT: Scoli-RISK-1 is a multicenter prospective cohort designed to study neurologic outcomes following complex adult spinal deformity (ASD). The effect of unilateral versus bilateral postoperative motor deficits on the likelihood of long-term recovery has not been previously studied in this population.

PURPOSE: To evaluate whether bilateral postoperative neurologic deficits have a worse recovery than unilateral deficits.

STUDY DESIGN: Secondary analysis of a prospective, multicenter, international cohort study.

METHODS: In a cohort of 272 patients, neurologic decline was defined as deterioration of the American Spinal Injury Association Lower Extremity Motor Scores (LEMS) following surgery. Patients with lower extremity neurologic decline were grouped into unilateral and bilateral cohorts. Differences in demographics, surgical variables, and patient outcome measures between the two cohorts were analyzed.

RESULTS: A total of 265 patients had LEMS completed at discharge. Unilateral decline was seen in 32 patients (12%), while 29 (11%) had bilateral symptoms. At 2 years, there was no significant difference in either median LEMS (unilateral 50.0, interquartile range [IQR] 47.5-50.0; bilateral 50.0, IQR 48.0-50.0, p=.939) or change in LEMS from baseline (unilateral 0.0, IQR -1.0 to 0.0; bilateral 0.0, IQR -1.0 to 0.0, p=.920). In both groups, approximately two-thirds of patients saw recovery to at least their preoperative baseline by 2 years postoperatively (unilateral n=15, 63%; bilateral n=14, 67%). The mean Scoliosis Research Society-22R (SRS-22R) score at 2 years was 3.7±0.6 versus 3.2±0.6 (p=.009) for unilateral and bilateral groups, respectively.

CONCLUSIONS: The prognosis for neurologic recovery of new motor deficits following complex adult spinal deformity is similar with both unilateral and bilateral weaknesses. Despite similar rates of neurologic recovery, patient reported outcomes for those with bilateral motor decline measured by SRS-22R are worse at 2 years after surgery.

OriginalsprogEngelsk
TidsskriftThe spine journal : official journal of the North American Spine Society
Vol/bind19
Udgave nummer3
Sider (fra-til)395-402
ISSN1529-9430
DOI
StatusUdgivet - 2019

ID: 56467727