Document Detail


Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience.
MedLine Citation:
PMID:  23288452     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study analyses the complications of spinal deformity surgery in adults to highlight pre-disposing factors.
METHODS: The clinical records and imaging were reviewed for 48 consecutive patients, 12 males and 36 females, with a mean age of 64 (31-86), who had surgery for spinal deformity. Mean follow-up time was 36 months (24-60). Patient data recorded were age, diagnosis and co-morbidities; deformity assessment: curve type, sagittal and coronal balance, Cobb angle. Operation details: number of instrumented levels, duration and intra-operative complications.
OUTCOME: complications, re-operations, balance and Cobb angle.
RESULTS: 28 patients (58 %) had at least 1, 15 patients (27 %) had 2 and 5 patients (9.5 %) had more than 2 co-morbidities. Average time between 1st presentation and operation was 13 months (1-41). The mean number of levels fused was 10.8 (4-23). In addition to posterior pedicle screw instrumentation, 40 patients had chevron osteotomies and 8 had pedicle substraction osteotomies. Posterior interbody fusions were performed at one level in 17 of which 7 had 2 level fusion. Two patients had combined anterior and posterior approaches. Fusion to the pelvis was performed in 19 patients. There were a total of 27 major and minor complications in 19/48 (39.5 %) patients. Late complications included 5 patients who had revisions for proximal junctional kyphosis, 1 patient had revision for pseudoarthrosis and 4 patients had removal of mal-positioned screws.
CONCLUSIONS: Factors associated with high complication rate in adult spinal deformity surgery are age, co-morbidities and severe sagittal imbalance at the time of presentation.
Authors:
Shaishav Bhagat; V Vozar; L Lutchman; R J Crawford; A S Rai
Publication Detail:
Type:  Journal Article     Date:  2013-01-04
Journal Detail:
Title:  European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society     Volume:  22 Suppl 1     ISSN:  1432-0932     ISO Abbreviation:  Eur Spine J     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-22     Completed Date:  2013-08-27     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  9301980     Medline TA:  Eur Spine J     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  S42-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Comorbidity
Female
Great Britain / epidemiology
Humans
Male
Middle Aged
Orthopedic Procedures / adverse effects*,  mortality
Reoperation / statistics & numerical data
Retrospective Studies
Spinal Curvatures / radiography,  surgery*
Spine / radiography,  surgery*
Comments/Corrections

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