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European Spine Journal

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01-06-2016 | Original Article

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

Authors: Jun-lin Yang, Zi-fang Huang, Jun-qiang Yin, Yao-long Deng, Xian-biao Xie, Fo-bao Li, Jing-fan Yang

Published in: European Spine Journal | Issue 6/2016

Abstract

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. Based on neurophysiological monitoring, magnetic resonance imaging, and neurological symptoms patients were categorized into three groups: group A, normal spinal cord, normal evoked potentials and no neurological symptoms; group B, spinal cord abnormalities and/or abnormal evoked potentials but no neurological symptoms; group C, neurological symptoms with or without spinal cord abnormalities/abnormal evoked potentials. Outcomes and complications were compared between the groups.

Results

A total of 89 patients (51 male, 38 female) were included with 47 (52.8 %), 16 (18.0 %), and 26 (29.2 %) patients in groups A, B and C, respectively, and a mean follow-up 34.5 months. There were no differences in age, gender, average preoperative scoliosis, and kyphosis among three groups, but there were differences with respect to the causes of severe spinal deformity and the corrective rate of scoliosis and kyphosis. Changes in intraoperative evoked potentials were different in these three types according to this new classification, and the recovery rates of changes in the three groups were 71.1, 50.0, and 14.1 %, respectively. Postoperative spinal cord injury was positively related to intraoperative changes of evoked potentials.

Conclusion

The classification system may be useful for guiding surgical decisions in patients with severe spinal deformities to minimize the risk of neurological complications.

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Title: A proposed classification system for guiding surgical strategy in cases of severe spinal deformity based on spinal cord function
Authors: Jun-lin Yang
Zi-fang Huang
Jun-qiang Yin
Yao-long Deng
Xian-biao Xie
Fo-bao Li
Jing-fan Yang
Publication date: 01-06-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 6/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-015-4367-2

ACC 2024 Congress

Springer Medicine

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

Abstract

Purpose

Methods

Results

Conclusion

ACC 2024 Congress

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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