Speaker: Risk of neurologic complications should not contraindicate three-column osteotomy
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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.
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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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