Cargando…

Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences

The aim was to investigate the role of preoperative magnetic resonance imaging (MRI) and intraoperative monitoring (IOM) in the prevention of correction-related complications in idiopathic scoliosis (IS). We conducted a retrospective case study of 129 patients with juvenile and adolescent IS. The op...

Descripción completa

Detalles Bibliográficos
Autores principales: Pazarlis, Konstantinos, Jonsson, Håkan, Karlsson, Thomas, Schizas, Nikos
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104016/
https://www.ncbi.nlm.nih.gov/pubmed/35566726
http://dx.doi.org/10.3390/jcm11092602
_version_ 1784707691653890048
author Pazarlis, Konstantinos
Jonsson, Håkan
Karlsson, Thomas
Schizas, Nikos
author_facet Pazarlis, Konstantinos
Jonsson, Håkan
Karlsson, Thomas
Schizas, Nikos
author_sort Pazarlis, Konstantinos
collection PubMed
description The aim was to investigate the role of preoperative magnetic resonance imaging (MRI) and intraoperative monitoring (IOM) in the prevention of correction-related complications in idiopathic scoliosis (IS). We conducted a retrospective case study of 129 patients with juvenile and adolescent IS. The operations took place between 2005 and 2018 in Uppsala University Hospital. Data from MRI scans and IOM were collected. The patients were divided into groups depending on Lenke’s classification, sex, major curve (MC) size, and onset age. Neurophysiological incidences were reported in ten patients (7.8%), while nine of them had no signs of intraspinal pathology. Six patients (4.7%) had transient incidences; however, in four patients (3.1%), an intervention was required for the normalization of action potentials. Three of them had an MC >70 degrees, which was significantly higher than the expected value. Eight patients (6.1%) had intraspinal pathologies, and two of them (1.5%) underwent decompression. We suggest the continuation of MRI screening preoperatively and, most importantly, the use of IOM. In three cases with no signs of pathology in the MRI, IOM prevented possible neurological injuries. MCs >70 degrees should be considered a risk factor for the occurrence of neurophysiological deficiencies that require action to be normalized.
format Online
Article
Text
id pubmed-9104016
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91040162022-05-14 Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences Pazarlis, Konstantinos Jonsson, Håkan Karlsson, Thomas Schizas, Nikos J Clin Med Article The aim was to investigate the role of preoperative magnetic resonance imaging (MRI) and intraoperative monitoring (IOM) in the prevention of correction-related complications in idiopathic scoliosis (IS). We conducted a retrospective case study of 129 patients with juvenile and adolescent IS. The operations took place between 2005 and 2018 in Uppsala University Hospital. Data from MRI scans and IOM were collected. The patients were divided into groups depending on Lenke’s classification, sex, major curve (MC) size, and onset age. Neurophysiological incidences were reported in ten patients (7.8%), while nine of them had no signs of intraspinal pathology. Six patients (4.7%) had transient incidences; however, in four patients (3.1%), an intervention was required for the normalization of action potentials. Three of them had an MC >70 degrees, which was significantly higher than the expected value. Eight patients (6.1%) had intraspinal pathologies, and two of them (1.5%) underwent decompression. We suggest the continuation of MRI screening preoperatively and, most importantly, the use of IOM. In three cases with no signs of pathology in the MRI, IOM prevented possible neurological injuries. MCs >70 degrees should be considered a risk factor for the occurrence of neurophysiological deficiencies that require action to be normalized. MDPI 2022-05-05 /pmc/articles/PMC9104016/ /pubmed/35566726 http://dx.doi.org/10.3390/jcm11092602 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pazarlis, Konstantinos
Jonsson, Håkan
Karlsson, Thomas
Schizas, Nikos
Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title_full Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title_fullStr Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title_full_unstemmed Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title_short Preoperative MRI and Intraoperative Monitoring Differentially Prevent Neurological Sequelae in Idiopathic Scoliosis Surgical Correction, While Curves >70 Degrees Increase the Risk of Neurophysiological Incidences
title_sort preoperative mri and intraoperative monitoring differentially prevent neurological sequelae in idiopathic scoliosis surgical correction, while curves >70 degrees increase the risk of neurophysiological incidences
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104016/
https://www.ncbi.nlm.nih.gov/pubmed/35566726
http://dx.doi.org/10.3390/jcm11092602
work_keys_str_mv AT pazarliskonstantinos preoperativemriandintraoperativemonitoringdifferentiallypreventneurologicalsequelaeinidiopathicscoliosissurgicalcorrectionwhilecurves70degreesincreasetheriskofneurophysiologicalincidences
AT jonssonhakan preoperativemriandintraoperativemonitoringdifferentiallypreventneurologicalsequelaeinidiopathicscoliosissurgicalcorrectionwhilecurves70degreesincreasetheriskofneurophysiologicalincidences
AT karlssonthomas preoperativemriandintraoperativemonitoringdifferentiallypreventneurologicalsequelaeinidiopathicscoliosissurgicalcorrectionwhilecurves70degreesincreasetheriskofneurophysiologicalincidences
AT schizasnikos preoperativemriandintraoperativemonitoringdifferentiallypreventneurologicalsequelaeinidiopathicscoliosissurgicalcorrectionwhilecurves70degreesincreasetheriskofneurophysiologicalincidences