Risk Factors ID’d for Massive Blood Loss in Scoliosis Surgery

For patients undergoing scoliosis surgery, the risk of massive blood loss is increased with preoperative Cobb angles bigger than 50 degrees and for those undergoing osteotomy or fusion of more than six levels, according to a study published in the Feb. 15 issue of Spine.
 

 For patients undergoing scoliosis surgery, the risk of massive blood loss is increased with preoperative Cobb angles bigger than 50 degrees and for those undergoing osteotomy or fusion of more than six levels, according to a study published in the Feb. 15 issue of Spine.

  

Include pre-op Cobb angle larger than 50 degrees, osteotomy, or fusion of more than six levels 




Xuerong Yu, M.D., from Peking Union Medical College Hospital in Beijing, and colleagues retrospectively analyzed data from patients undergoing scoliosis surgery, from June 1, 2011 to Oct. 31, 2011, based on their classification as having lost more than 30 percent of estimated blood volume (group A; 95 patients) and those who lost 30 percent or less of their blood volume (group B; 64 patients). Total blood loss was defined as the sum of intraoperative and postoperative estimated blood loss.

The researchers found that 59.7 percent of the patients had massive blood loss. There were significant differences between the groups with patients in group A shorter, with larger preoperative Cobb angles, more levels fused, and more osteotomies than patients in group B. Independent risk factors for massive blood loss included preoperative Cobb angle of more than 50 degrees (odds ratio [OR], 2.47), more than six levels fused (OR, 3.70), and osteotomy (OR, 4.64).
"In conclusion, patients with preoperative Cobb angle larger than 50 degrees or patients planning to undergo osteotomy or fusion of more than six levels have an increased risk of massive blood loss," write the authors. "This may contribute to an improved use of blood conservation strategy."

Source : Doctors Lounge ( 8th march 2013 )

Shalimar boy undergoes two surgeries to fix scoliosis

 

Tanner Dubose had to wear a halo before the first of his two surgeries. 

The first time Bill Dubose remembers his son Tanner showing him a lump on the left shoulder blade was about three years ago.
It wasn’t hurting his then 9-year-old son or keeping him from doing anything, so Dubose suggested they watch it and bring it up at his next doctor’s visit.
Just in the last six months the lump quickly worsened into life-threatening scoliosis. Tanner had a 127-degree curve in his spine that endangered his heart and lungs.
When a local doctor deemed Tanner’s case too severe for him to fix, his family in Shalimar began looking elsewhere.
“It crossed his mind that maybe no one could do anything,” Dubose said from Shriners Hospitals for Children in St. Louis, where Tanner has undergone two surgeries to straighten his spine. “I was devastated inside.”
Dubose and now 11-year-old Tanner have been at the hospital since January.
His first surgery Feb. 28 was the preparation for the second, more complicated one, Dubose said.
During the second surgery Thursday, part of Tanner’s vertebrae was removed and rods and plates were attached to the rest of his spine. Surgery on scoliosis as severe as Tanner’s is rare, so it was watched by more than 100 doctors through a live feed to an auditorium.
In six months to a year, Tanner’s spine and the equipment will fuse together. For now, Tanner won’t be able to lift more than 5 pounds for about a month.
“He’s going to get proficient in video games and homework,” his father joked.
Tanner will get a souvenir, however.
He’s taking home his “halo,” a horseshoe shaped piece of metal that was screwed to his skull for about two months before the surgeries. Weights were attached to the halo through a pulley system to help start straightening his spine and prepare him for the operations.
The only time Tanner went without the halo and weights was when he took a shower. Tanner’s always been a good sleeper, Dubose said, so only some extra fluffy pillows were needed.
“I think he’s grown a few inches,” Dubose said. “I think he has gotten straighter and not hunched over as much.”
Tanner said the halo hurt for about the first week, but then it became normal.
“I hardly noticed it,” he said.
Tanner walked on the treadmill for 30 minutes with the halo weights two times a day, five days a week before the surgeries. His perseverance inspired his father to work on his own health.
“If my son, who’s in this condition, can do this, I can do it,” Dubose said.
Tanner is taking it all in stride. In some ways, he is older than his 11 years, his father said.
“He likes normal kid stuff, but he also wakes up to watch The Weather Channel to learn how to prepare for that day,” he said.
Tanner was nervous when he first learned about the upcoming surgeries. And it’s been hard to be in St. Louis without his mom and three sisters, he said.
There is no timetable for him and his father to come home.
When Tanner does return, “I’ll go visit my friends and spend time with my family. Just do whatever I did before,” he said.


Source : nwf daily news 

Rare Kyphoscoliosis spine surgery performed in Tirupur

The Tirupur-based Revathi Medical Centre has claimed to have performed a rare surgery to correct Kyphoscoliosis, an abnormal curvature of the spine, on a 23-year-old woman M.Manimeghalai who hails from The Nilgiris district. 

The surgery that lasted 12 hours was performed by spine surgery team comprising Gurusamy Nachimuthu, K. Dhanasekar, R. Raja and R. Eswaramurthi. 

Mr. Eswaramurthi, managing director of Revathi Medical Centre, told reporters that the deformity to the spine of the girl was found progressing over the period and she had severe pain that restricted her movements.

“She has been admitted to the hospital with twisted spine, short trunk and early myelopathy (ie nerve dysfunctions),” he said. The surgery was performed only after briefing the patient as well as her parents of the risks in the surgery like its long duration, possibilities of paralysis and massive blood loss.

Post surgery, the spine curvature of the girl has returned to near normal range. The patient, according to the hospital sources, can return to normal activities after six months. 

“If patient has come at an earlier stage, the magnitude of the surgery could have been much lesser,” Dr. Eswaramurthi said. 

Source : The Hindu , Tirupur , 7th March 2013