Transcript British Spinal Registry - British Scoliosis Society

British Spinal Registry
British Association of Spine Surgeons
Middlesbrough
February 2007
John O’Dowd
Nicky Courtier
Low back data set

538 cases
 Mean age 52
 Male/female
45/55 %
 Pain
• Back
11.3%
• Leg
16.6%
• Back and leg
72.1%
Low back data set

538 cases
 Diagnosis
• Disc herniation
• Stenosis
• Degenerative spondylolisthesis
14.6%
• Degenerative scoliosis
• Previous decompression
• Previous fusion
39.1%
36.3%
1.2%
6.1%
2.5%
Low back data set

Procedure










Discectomy
Segmental decompression
Foraminotomy
Laminectomy
Posterolateral fusion
Anterior fusion
Circumferential fusion
Stabilisation
Arthroplasty
Revision decompression
37.9%
46%
14%
10.7%
20%
1.6%
0.4%
17.86%
2.5%
3.3%
Low back data set
 Implant







None
Translaminar screws
Pedicle screws
DYNESYS
Wallis
Cage
Disc arthoplasty
53.4%
0.4%
24.1%
14.6%
4.4%
2.4%
3%
Low back data set

Complications

Nerve root injury

Cauda equina

Dural tear

CSF leak

Infection

Early revision
n=2
n=0
n=20
n=10
n=6
n= 4
% if full reporting
0.4%
0
3.7%
1.8%
1.1%
0.7%
SINGLE LEVEL LUMBAR
DISCECTOMY

Total cases





Age 43.36 M/F 62%/38%
Level

L3/4
3.8%
L4.5
38.1%
L5/S1 58.1%
Side


106
Left
Right
49%
51%
BASS Audit

Decompression



91%
9%
Microscope



Yes
No
Yes
No
3%
97%
Intraoperative xray to confirm level


Yes
No
29.6%
70.4%
BASS Audit
 Disc



Sequestered
12.6%
Extruded
17.9%
Contained 69.5%
 Pre



op
ODI average
49.3% ( n=23)
VAS leg
6.2 (n=25)
VAS back 5.6 (n=21)
BASS Audit

Dural tear



2.9%
97.1%
Arachnoid intact



Yes
No
Yes
No
42.9%
57.1%
Free CSF


Yes
No
37.5%
62.5%
BASS Audit

Tear repaired




Yes
No
40% (n=2)
60% (n=3)
Patch



20% (n=1)
80% (n=4)
Suture


Yes
No
Yes
No
20% (n=1)
80% (n=4)
Drain


Yes
No
80% (n=4)
20% (n=1)
BASS Audit
 Vascular
injury
 Blood loss > 250 mls
 Post op complications




Increased neurological deficit
Recurrence < 3months
Infection
Reoperation all causes
0
0
2.4% (n=2)
n=1
n=1
n=1 (1.3%)
n=0