Neurologic Complications of Pedicle Subtraction Osteotomy: a Ten-Year Assessment

Materials and Methods: A review of 110 consecutive patients (83 women and 27 men) with an average age of 54.7±13.9 years and treated with a PSO at one institution over a ten-year period (1995-2005) was performed. Medical records, radiographs, and neuromonitoring data were analyzed.

Results: A total of 110 PSOs were performed. Following surgery, thoracic kyphosis increased from +28.2±18.6º to +35.4±14.7º (p<0 .012), lumbar lordosis increased from -16.3±19.5º to -50.2±15.2º (p<0.001), and sagittal balance improved +137±72mm +21±52mm (p<0.001). Intra- post-operative deficits (defined as motor loss of two grades or more bowel/bladder control) were seen in twelve patients (10.9%). Deficits found intraoperatively during a wake-up test three patients, immediately postoperatively four delayed manner five patients. Intraoperative neuromonitoring did not detect the deficits. In eight additional surgical intervention consisted central enlargement further decompression. thought be due combination subluxation, residual dorsal impingement, dural buckling. They always unilateral, never proximal usually correspond level osteotomy. ranged neurogenic bladder (one patient) weakness TA (seven patients), quadriceps (five EHL (four patients) with having multiple muscle groups. Three (2.7%) had permanent including patient), both quadriceps/TA patient). With time function by one grade all able ambulate.

Conclusion: Intra- or post-operative neurologic deficits are relatively common following a PSO, however, in a majority of cases deficits are not likely to be permanent.