Incidence and risk factors of neurological deficits of surgical correction for scoliosis: analysis of 1373 cases at one Chinese institution.

摘要

STUDY DESIGN: A retrospective study. OBJECTIVE: To investigate the incidence of neurologic deficits after scoliosis correction at 1 institution and identify the risk factors for such deficits in scoliosis correction. SUMMARY OF BACKGROUND DATA: Neurologic deficit is one of the risks of surgical correction of scoliosis. Reports of the incidence of the neurologic deficits involving a large number of cases at 1 institution are rare. METHODS: Statistical analysis of the neurologic deficits was performed in 1373 scoliosis cases treated at 1 institution by etiologies in light of the patients' sex, age, sagittal profile, surgical approach, Cobb's angle, and the type of surgery. RESULTS: The total incidence of neurologic deficits was 1.89% and that of serious and mild ones was 0.51% and 1.38%, respectively. The total incidence of neurologic deficits were 1.06% in adolescent idiopathic scoliosis patients and 2.89% in congenital scoliosis (CS) patients, 3.32% in scoliosis patients with hyperkyphosis (>40 degrees) and 1.38% in those without hyperkyphosis, 3.43% for combined procedures and 1.24% for single posterior procedures, 3.69% in patients with Cobb's angle more than 90 degrees and 1.45% in those with an angle less than 90 degrees , 1.68% with primary surgery and 5.97% with revision surgery, the difference between them was significant (P < 0.05). In adolescent idiopathic scoliosis patients, the incidence were 3.85% for combined procedures and 0.64% for posterior procedure, 0.82% with primary surgery and 8.33% with revision surgery, 4.17% with hyperkyphosis and 0.61% without hyperkyphosis, the difference between them was significant (P < 0.05). The incidence of CS patients with Cobb's angle more or less than 90 degrees were 7.23% and 1.68% and the difference was significant (P < 0.05). CONCLUSION: In surgical correction of scoliosis, the risk factors for neurologic deficits include CS, scoliosis with hyperkyphosis, scoliosis correction by combined procedures, scoliosis with a Cobb's angle more than 90 degrees , and a revision surgery.