Spine deformity · 2025
Exploring the indications, failures, and treatment of complications after a C2 to pelvis fusion.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lee Nathan J, Hassan Fthimnir M, Shi Ted, Ferraro Anastasia, Cooney Matthew, Hung Chun Wai, Roth Steven G, Scheer Justin K, Sardar Zeeshan M, Lombardi Joseph M, Lenke Lawrence G, Lehman Ronald A
Аннотация
PURPOSE: To better elucidate the C2-related complications and treatments among ASD patients with C2-ilium fusions.
METHODS: A single-center series of patients who underwent a posterior spinal instrumented fusion (PSIF) from C2-ilium were included. Patient demographics, medical history, diagnosis, operative procedures, and complications were analyzed.
RESULTS: 37 C2-ilium patients were included with a mean follow-up of 2.8 years, age of 56 ± 19 years, 57% were female, and 38% had osteoporosis/osteopenia. Most patients had a prior fusion surgery 81% (N = 30), which commonly included upper thoracic to sacrum (N = 15) and cervical-thoracic (N = 5) fusions. The most common surgical indications included PJK/F (N = 12), chin-on-chest deformity (N = 5), and pseudarthrosis (N = 5). The surgical complication rate was 46% (17/37), the revision surgery rate was 38% (14/37), and 3 patients required multiple revision surgeries. Reoperations commonly addressed C2-related fractures (N = 6), wound complications (N = 5), and pseudarthrosis unrelated to C2 (N = 4). For those with C2 issues, surgery included either extension of fusion to Occiput (N = 2) and C1 (N = 4) or revision C2 (N = 2). Four patients with radiographic C2 issues were treated non-operatively in a hard collar after appearing stable on repeat imaging.
CONCLUSION: This is the largest series of C2-ilium reconstructions with a mean follow-up of 2 years. The most common surgical indication was PJK/F, followed by chin-on-chest deformity and pseudarthrosis. The surgical complication and revision rate was 46% and 38%, respectively. The most common reason for revision surgery was C2-related fractures and screw loosening, with 43% being extended to C1 or the occiput. Long constructs from C2-ilium carry a high complication rate and require frequent follow-up to assess for long-term issues.
METHODS: A single-center series of patients who underwent a posterior spinal instrumented fusion (PSIF) from C2-ilium were included. Patient demographics, medical history, diagnosis, operative procedures, and complications were analyzed.
RESULTS: 37 C2-ilium patients were included with a mean follow-up of 2.8 years, age of 56 ± 19 years, 57% were female, and 38% had osteoporosis/osteopenia. Most patients had a prior fusion surgery 81% (N = 30), which commonly included upper thoracic to sacrum (N = 15) and cervical-thoracic (N = 5) fusions. The most common surgical indications included PJK/F (N = 12), chin-on-chest deformity (N = 5), and pseudarthrosis (N = 5). The surgical complication rate was 46% (17/37), the revision surgery rate was 38% (14/37), and 3 patients required multiple revision surgeries. Reoperations commonly addressed C2-related fractures (N = 6), wound complications (N = 5), and pseudarthrosis unrelated to C2 (N = 4). For those with C2 issues, surgery included either extension of fusion to Occiput (N = 2) and C1 (N = 4) or revision C2 (N = 2). Four patients with radiographic C2 issues were treated non-operatively in a hard collar after appearing stable on repeat imaging.
CONCLUSION: This is the largest series of C2-ilium reconstructions with a mean follow-up of 2 years. The most common surgical indication was PJK/F, followed by chin-on-chest deformity and pseudarthrosis. The surgical complication and revision rate was 46% and 38%, respectively. The most common reason for revision surgery was C2-related fractures and screw loosening, with 43% being extended to C1 or the occiput. Long constructs from C2-ilium carry a high complication rate and require frequent follow-up to assess for long-term issues.