AANS Beyond 2023: Neurosurgeon Collection-AANS/CNS Section on Disorders of the Spine & Peripheral Nerves Session

Video Transcription

Video Summary

In the first video summary, a case is discussed involving a 52-year-old woman with colorectal cancer who underwent radiation treatment for a T12 vertebral body lesion. Complications arose, including a fracture and retropulsion with epidural compromise, leading to surgical reconstruction. However, the patient later experienced leg weakness and severe pain, possibly due to instrumentation failure. This case highlights the importance of long-term follow-up for patients with spinal metastatic disease.<br /><br />In the second video summary, the American Spine Registry (ASR) is introduced as a collaboration between the American Association of Neurological Surgeons (AANS) and the American Academy of Orthopaedic Surgeons (AAOS). The registry collects data on spinal surgery procedures, including specifics on targeted pathology and patient-reported outcome measures (PROMs). It also integrates with CMS to track patient outcomes and complications, aiming to support evidence-based quality improvement in spine surgery.<br /><br />The third video summary focuses on a case where a patient developed bilateral dorsiflexion weakness after undergoing a four-to-one ALIF and a four-to-one MIS posterior procedure. The panel of experts advises on proactive measures to avoid potential litigation in such cases. Recommendations include open and honest communication with the patient, thorough documentation of discussions regarding risks and benefits, prompt evaluation with imaging to identify potential causes of neurological deficits, engagement with the patient and their family, and comprehensive documentation throughout the process. The experts also suggest video recording consent discussions for clear communication records. Overall, the panel emphasizes compassionate care and documentation to reduce litigation risks.

Keywords

colorectal cancer

radiation treatment

T12 vertebral body lesion

complications

fracture

retropulsion

epidural compromise

surgical reconstruction

leg weakness

severe pain

instrumentation failure

long-term follow-up

spinal metastatic disease

American Spine Registry

spinal surgery procedures