Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Mar;22 Suppl 1(Suppl 1):S42-6.
doi: 10.1007/s00586-012-2627-y. Epub 2013 Jan 4.

Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience

Shaishav Bhagat  1 , V Vozar, L Lutchman, R J Crawford, A S Rai
Affiliations

Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience

Shaishav Bhagat et al. Eur Spine J. 2013 Mar.

Abstract

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.

PubMed Disclaimer

References

    1. Pritchett JW, Bortel DT. Degenerative symptomatic lumbar scoliosis. Spine. 1993;18:700–703. doi: 10.1097/00007632-199305000-00004. - DOI - PubMed
    1. Silva FE, Lenke LG. Adult degenerative scoliosis: evaluation and management. Neurosurg Focus. 2010;28(3):E1. doi: 10.3171/2010.1.FOCUS09271. - DOI - PubMed
    1. Yadla Y, Maltenfort G, Ratliff JK, Harrop JS. Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus. 2010;28(3):E3. doi: 10.3171/2009.12.FOCUS09254. - DOI - PubMed
    1. Charosky S, Guigui P, Blamoutier A, Roussouly P, Chopin D. Complications and risk factors of primary adult scoliosis surgery. A multicenter study of 306 patients. Spine. 2012;37(8):693–700. doi: 10.1097/BRS.0b013e31822ff5c1. - DOI - PubMed
    1. Sansur CA, Smith JS, et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976) 2011;36(9):E593–E597. doi: 10.1097/BRS.0b013e3182059bfd. - DOI - PubMed

LinkOut - more resources