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The Journal of Bone and Joint Surgery 80:1679-83 (1998)
© 1998 The Journal of Bone and Joint Surgery, Inc.

Dysfunction of the Spinal Cord During Spinal Arthrodesis for Scoliosis: Recommendations for Early Detection and Treatment. A Case Report*

VITO POTENZA, M.D.{dagger}, STUART L. WEINSTEIN, M.D.{ddagger} and JEROEN G. NEYT, M.D.{ddagger}, IOWA CITY, IOWA

Investigation performed at University of Iowa Hospitals and Clinics, Iowa City


   Introduction
 
Numerous factors can increase the risk of neurological injury during an operation for the correction of scoliosis; these include the presence of a congenital, severe, or rigid curve and the presence of abnormalities in the spinal cord27. Factors related to anesthesia, such as hemodilution and induced hypotension, may produce ischemia of the spinal cord16,15,27. Sublaminar wiring and derotation or distraction of the spinal column may also result in injury3,10,15,26. A careful clinical, neurological, and radiographic assessment is warranted for any patient who has scoliosis, especially when there are unusual findings; these findings may include the onset of scoliosis before the age of ten years, rapid progression of the curve, clinical symptoms such as back pain and headache, neurological symptoms or signs, and an atypical curve pattern2,23.

Preoperative magnetic resonance imaging of the spine may demonstrate intraspinal abnormalities, such as syringomyelia associated with Chiari type-I malformation, spinal . . . [Full Text of this Article]


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