One-stage Combined Surgical Treatment of Spinal Deformity and Medulla Spinalis Abnormality
Journal Title: Istanbul Medical Journal - Year 2020, Vol 21, Issue 3
Abstract
Introduction: Congenital spinal deformities accompanied by medulla spinalis anomalies are relatively common conditions and can lead to severe complications when left untreated. The conventional treatment approach for severe spine deformity with medulla abnormality is at least a two-stage surgery performed at different times by an orthopaedic and neurosurgeon. However, this might increase hospitalisation time, cost and complication rates. In this study, we aimed to retrospectively evaluate the results of the simultaneous correction of spinal and medulla spinalis deformities in the paediatric population and compare the outcomes with a control group. Methods: The study included 26 patients with spinal deformities such as rigid scoliosis and kyphosis who underwent a deformity correction surgery and 8 patients who underwent a simultaneous correction of spinal and medulla spinalis deformities. Diagnosis, age, additional pathologies and neurological and radiological findings were recorded. Intraoperative and postoperative measures including operation time, intensive care unit (ICU) duration, hospital stay, blood loss, any early and late complications and second revision surgery requirements were evaluated and reported. Results: The mean operation time was 5.8 (range, 5-8) h in the study group and 3.4 h (range, 3-5) h in the control group (p<0.05). The mean blood loss was 1720 (range, 1400-2400) mL in the study group and 1410 (range, 1200-2000) mL in the control group. The mean hospitalisation times were 6.4 (range, 5-9) and 4.2 (range, 3-7) days in the study and control groups, respectively (p<0.05). Conclusion: One-stage orthopaedic and neurosurgical intervention is a safe and convenient approach and does not increase complication risks. Also, the long duration of the surgery does not adversely affect the length of ICU stay and the volume of blood loss.
Authors and Affiliations
Murat Mert, Mete Karatay
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