[Neurologic complications of surgery of the spine in children].
Neurological deficiency can occur during or after spinal surgery. The most severe complications are seen after instrumental correction for scoliosis or kyphosis. Regression of paraplegia, paraparesia and Brown-Sequard syndrome is never a certainty and usually incomplete. Preoperative manoeuvres and evoked potentials do not provide absolute security and metal instrumentation should always be used prudently. The main risk factors are vertebral malformation, major kyphosis, preoperative signs of neurological deficit, excessive correction and double anterior and posterior access. Finally, the canal is poorly vascularized from T4 to T8 or T9 which can raise further problems. Cordal deficiency during or following almost always requires removal of the metal implant, and exploration of the canal possibly with MRI. Injury include direct contusion of the spinal cord, devascularization and compressive haematomas. The frequency of neurological complications is currently about 1% and only extreme prudence and knowledge of causes can reduce this rate.
Carlioz
H
H
Hôpital Trousseau, Orthopédie et chirurgie réparatrice de l'enfant, Paris.
Ouaknine
M
M
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007738:Kyphosis / Q000151:congenital / Q000601:surgery*; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D011379:Prognosis; D012086:Reoperation; D012307:Risk Factors; D012600:Scoliosis / Q000151:congenital / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects*
Complications neurologiques de la chirurgie du rachis chez l'enfant.