Speaker: Risk of neurologic complications should not contraindicate three-column osteotomy
Key takeaways:
- Three-column osteotomy for adult spinal deformity may be associated with neurologic complications.
- However, risk of neurologic complications should not deter surgeons from performing three-column osteotomy.
According to presented results, patients who undergo three-column osteotomy for adult spinal deformity may have an increased risk for neurologic complications compared with patients who undergo surgery without three-column osteotomy.
However, Andrew Kim, BS, said the risk of neurologic complications should not deter surgeons from performing three-column osteotomy in this population, as most patients achieved motor recovery at 1 year.
“Risk of neurologic complications should not be considered a contraindication to performing three-column osteotomy among adult spinal deformity patients,” Kim, a clinical research fellow in the department of orthopedic surgery at Johns Hopkins Medicine, told Healio.
At the North American Spine Society Annual Meeting, Kim presented results from a multicenter, prospective cohort study of 553 patients who underwent surgery for adult spinal deformity. Among the cohort, 130 patients (23.5%) underwent three-column osteotomy.
Kim and colleagues found patients who had three-column osteotomy had longer OR times (455.58 minutes vs. 407.24 minutes) and greater estimated blood loss (1,971.23 cc vs. 1,286.18 cc) vs. patients who did not have three-column osteotomy.
Kim and colleagues also found patients who had three-column osteotomy had a greater overall incidence of neurologic complications (23.08% vs. 15.37%) vs. patients who did not have three-column osteotomy. They noted 63.33% of neurologic complications occurred prior to discharge, and motor deficits were the most common neurologic complication.
However, Kim and colleagues found 85% of patients who underwent three-column osteotomy achieved motor recovery at 1 year, with 15% of patients experiencing residual motor deficit.
“Surgeons should ultimately choose a procedure they find best to correct the patient's spinal deformity based on the patient's individual risk profile, surgeon experience and expertise,” Kim concluded.
Collapse
Kim A, et al. Neurologic adverse events following three-column osteotomy: A prospective multicenter study. Presented at: North American Spine Society Annual Meeting; Sept. 23-28, 2024; Chicago.
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