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. 2014 Jan;38(1):117-22.
doi: 10.1007/s00264-013-2103-2. Epub 2013 Sep 22.

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

Baorong He  1 , Liang Yan, Zhengwei Xu, Hua Guo, Tuanjiang Liu, Dingjun Hao
Affiliations

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

Baorong He et al. Int Orthop. 2014 Jan.

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.

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Figures

Fig. 1
Fig. 1
Lesions primarily located at the disc level and caused by ossification of posterior longitudinal ligament and ligamentum flavum
Fig. 2
Fig. 2
Posterior laminectomy performed using a high-speed drill (uncovering method)
See this image and copyright information in PMC

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