Evidence map›Paper›PMID 42545585›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2026

Postoperative neurological deficits following thoracic decompression surgery: incidence, trajectory, and resolution.

Sennay Ghenbot, Hershil Patel, Sapan Patel, Rohan I Suresh, Anthony K Chiu, Amil Sahai, Hans Prakash, Evan Honig, Ryan Curto, Usman Zareef and 8 more

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

18 authors.

Sennay GhenbotDepartment of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, USA.
Hershil PatelDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Sapan PatelDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Rohan I SureshDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Anthony K ChiuDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Amil SahaiDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Hans PrakashDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Evan HonigDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Ryan CurtoDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Usman ZareefDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Brian ShearDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Idris AminDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Alexander PadovanoDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Louis J BivonaDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Daniel L CavanaughDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Eugene Y KohDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Steven C LudwigDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA.
Julio J JaureguiDepartment of Orthopaedics, University of Maryland Medical Center, Baltimore, USA. jjauregui@som.umaryland.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo characterize neurological outcomes after thoracic decompression and to identify patient- and procedure-level factors associated with persistent postoperative neurological deficits across a multi-etiology cohort, with explicit pathology-stratified analysis.

methodsWe retrospectively reviewed 255 patients who underwent thoracic decompression from 2016 to 2023 for degenerative disease (n = 102), trauma (n = 53), infection (n = 37), tumor (n = 28), or deformity (n = 35), classified under a mutually exclusive primary-indication scheme. Neurological deficits were assessed pre- and postoperatively using the ASIA Impairment Scale and detailed neurological examinations. Outcomes were stratified by surgical indication to address inherent pathologic heterogeneity. Categorical comparisons used chi-square or Fisher's exact tests; significance threshold p < 0.05 for hypothesis-driven analyses, with p < 0.001 retained for the descriptive comorbidity comparisons in Tables 4, 5 and 6 due to the large number of contrasts.

resultsThe cohort comprised 255 patients (mean age 62.6 ± 13.8 years; 51.4% female). New postoperative neurologic deficits occurred in 68 patients (26.7%) and were uniformly distributed across surgical indications (range 20.0-31.4%, p = 0.566), supporting a procedure-level interpretation of the aggregate risk. Recovery prospects, however, differed significantly by indication: persistent deficits at one year occurred in 2 of 25 evaluable degenerative cases (8.0%) versus 7 of 19 non-degenerative cases (36.8%; Fisher's exact p = 0.027). Baseline and postoperative neurologic burden also differed substantially by indication, with trauma patients showing the most severe deficits at both time points (preoperative ASIA A-C 34.0% vs. 4.9% in degenerative, p < 0.001; postoperative motor deficit 54.7% vs. 29.4%, p < 0.001; postoperative bowel/bladder dysfunction 22.6% vs. 8.8%, p = 0.008). Median time to deficit resolution was 23 days (IQR 9-68).

conclusionNew postoperative neurological deficits after thoracic decompression occurred in approximately one in four patients in this pathology-inclusive cohort. Most deficits with adequate follow-up resolved, but persistent deficits occurred in a clinically meaningful subset and could not be fully determined in patients lost to follow-up before one year. Although the incidence of new postoperative deficit was similar across indications, recovery appeared to vary by pathology, with lower persistent-deficit rates among evaluable degenerative cases than non-degenerative cases. These findings are descriptive and hypothesis-generating and should be validated in larger, pathology-specific cohorts with complete longitudinal follow-up.

Indexed as

Decompression, SurgicalNervous System DiseasesPostoperative ComplicationsThoracic VertebraeAgedFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesPostoperative neurological deficitsThoracic myelopathyThoracic spinal decompression

Identifiers

PMID42545585

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.