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Archives of Orthopaedic and Trauma Surgery

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01-02-2005 | Original Article

Iatrogenic paraplegia in spinal surgery

Authors: K.-S. Delank, H. W. Delank, D. P. König, F. Popken, S. Fürderer, P. Eysel

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 1/2005

Abstract

Introduction

Paraplegia as a result of a surgical spinal procedure is a rare complication. The risk cannot be precisely quantified due to the lack of current data. The aim of this study was to record a sufficiently large number of major spinal operations, especially extended methods in scoliosis surgery. Hereby, a reliable statement regarding the risk of severe neurological complications with these surgical techniques should be possible. First, a retrospective analysis of patients from a German spine centre (spinal fusion) and a survey of 17 German centres of spinal surgery were conducted for the retrospective acquisition of severe iatrogenic neurological complications.

Materials and methods

The study included 1194 patients who underwent a spinal fusion during the period 1992–2002. The incidents of postoperative paraplegia are described in detail, and case studies done. Possible causes, methods of intraoperative monitoring and options of therapy are discussed according to research in relevant publications. Additionally, severe neurological complications of 3115 spinal operations were recorded in a standardised survey conducted throughout major German spinal centres.

Results

Of the 1194 patients surveyed, 7 (0.59%) experienced a postsurgical complete or incomplete paraplegia. In 3 of the recorded cases, the cause could be identified. The survey of 3115 scoliosis surgeries showed that iatrogenic paraplegia occurred with a frequency of 0.55%. The risks associated with short spinal fusions (0.14%), cervical discectomies (0.07%) and lumbar discectomies (0.03%) are considerably less.

Conclusion

Operative treatment of scoliosis with a high degree of correction carries a risk of neurological complications of about 0.5%. Mechanical as well as ischaemic damage to the spinal cord can be detected early by means of consistent intraoperative neuromonitoring.

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Title: Iatrogenic paraplegia in spinal surgery
Authors: K.-S. Delank
H. W. Delank
D. P. König
F. Popken
S. Fürderer
P. Eysel
Publication date: 01-02-2005
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 1/2005
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-004-0763-5

At a glance: The STEP trials

Springer Medicine

Iatrogenic paraplegia in spinal surgery

Abstract

Introduction

Materials and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusion

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