Paraplegia resulting from vessel ligation.
METHODS
This is a retrospective review of clinical records for evidence of paraplegia specifically resulting from segmental vessel ligation during anterior spinal surgery.


OBJECTIVE
To determine the precise risk rate, and to potentially identify risk factors.


BACKGROUND
Although many authors have alluded to this risk, the exact risk rate and risk factors have never been identified.


METHODS
All patients having an anterior approach involving T1-L3 were reviewed. The two reviewers were not involved in any of the surgeries. The 1197 cases were consecutive from 1967 to 1991.


RESULTS
There were no paralyses.


CONCLUSIONS
There would appear to be virtually no risk to segmental vessel ligation provided: 1) vessel ligation is unilateral, 2) done on the convexity of a scoliosis, 3) ligated at midvertebral body level, and 4) hypotensive anesthesia is avoided. Soft clamping with somatosensory-evoked potential monitoring does not appear justified.
Winter
R B
RB
Minnesota Spine Center, Minneapolis, USA.
Lonstein
J E
JE
Denis
F
F
Leonard
A S
AS
Garamella
J J
JJ
D000328:Adult; D002648:Child; D006801:Humans; D008026:Ligation; D008159:Lumbar Vertebrae / Q000601:surgery; D010264:Paraplegia / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013123:Spinal Fusion / Q000009:adverse effects / Q000379:methods; D013131:Spine / Q000098:blood supply* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000601:surgery; D013908:Thoracotomy; D014656:Vascular Surgical Procedures / Q000009:adverse effects