International Orthopaedics

, Volume 38, Issue 1, pp 117–122

Treatment strategies for the surgical complications of thoracic spinal stenosis: a retrospective analysis of two hundred and eighty three cases

Authors

  • Baorong He
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
  • Liang Yan
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
  • Zhengwei Xu
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
  • Hua Guo
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
  • Tuanjiang Liu
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
    • Department of Spine Surgery, Hong Hui HospitalXi’an Jiaotong University College of Medicine
Original Paper

DOI: 10.1007/s00264-013-2103-2

Cite this article as:
He, B., Yan, L., Xu, Z. et al. International Orthopaedics (SICOT) (2014) 38: 117. doi:10.1007/s00264-013-2103-2

Abstract

Purpose

Our aim was to investigate the causes of and treatment strategies for surgical complications of thoracic spinal stenosis.

Methods

Between May 1990 and May 2010, 283 patients with thoracic spinal stenosis were treated in our department. Three physicians were assigned to patient follow-up. Patient medical records and radiographs were reviewed. Complications were categorised as perioperative, mid- to long-term and donor-site.

Results

Follow-up was completed for 254 patients; 249 patients survived. Follow-up time ranged from one to 19 years, with a mean of six years and two months. There were 107 cases with complications an incidence rate of 42.1 %. Eleven cases were pulmonary infection, seven transient nerve-root injury, three pulmonary injury and one vertebral canal haematoma, all of which resolved. Thirteen cases of spinal cord injury postoperatively were treated using dehydration and corticosteroid therapy; eight recovered to the preoperation level, and five deteriorated. Eleven cases resulted in dural injury, and four led to cerebrospinal fluid leakage. There were five cases of wound-fat liquefaction and one of wound infection. Seven cases with deep venous thrombosis of the lower limb resolved by elevating the affected limb and administration of low-molecular-weight dextran. Seven cases of delayed wound healing recovered following change of dressings and antibiotic administration. Four cases of delayed bone-graft fusion recovered by extending the external fixation time. One case of bone-graft absorption was treated by iliac bone grafting and bracing. Two cases of internal fixation breakage were treated by removing the internal fixation.

Conclusions

Thoracic spinal stenosis surgery may result in various complications but has a good prognosis with proper treatment. The key points in reducing complications are the surgeon’s familiarity with operative imperatives and the appropriate surgical approach.

Keywords

Thoracic spinal stenosisComplicationsSurgeryPostoperative

Copyright information

© Springer-Verlag Berlin Heidelberg 2013