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. 2022 Jul;12(6):1135-1140.
doi: 10.1177/2192568220976562. Epub 2020 Dec 17.

Clinical Importance, Incidence and Risk Factors for the Development of Postoperative Ileus Following Adult Spinal Deformity Surgery

Tetsuro Ohba  1 , Kensuke Koyama  1 , Hiroki Oba  1   2 , Kotaro Oda  1 , Nobuki Tanaka  1 , Hirotaka Haro  1
Affiliations

Clinical Importance, Incidence and Risk Factors for the Development of Postoperative Ileus Following Adult Spinal Deformity Surgery

Tetsuro Ohba et al. Global Spine J. 2022 Jul.

Abstract

Study design: Retrospective observational study of a cohort of consecutive patients.

Objectives: Postoperative ileus (POI) is associated with a variety of adverse effects. Although the incidence of and risk factors for POI following spinal surgery have been reported, the frequency and pathology of POI after spinal corrective surgery for adult spinal deformity (ASD) are still largely unknown. The study objectives were to: (1) clarify the prevalence and clinical significance of POI, (2) elucidate the risk factors for POI, (3) determine radiographically which preoperative and/or postoperative spinal parameters predominantly influence the risk of POI after spinal corrective surgery for ASD.

Methods: We included data from 144 consecutive patients who underwent spinal corrective surgery. Perioperative medical complications and clinical information were extracted from patient electronic medical records. Preoperative radiographic parameters and changes in radiographic parameters after surgery were compared between patients with and without POI. Multivariate logistic regression analyses were performed to clarify potential risk factors for POI.

Results: POI developed in 25/144 (17.4%) patients and was the most common complication in the present study. The frequencies of smoking, gastroesophageal reflux disease, and lateral lumbar interbody fusion (LLIF), as well as the duration of surgery were significantly greater in the group with POI versus the group without POI. Among radiographic parameters, only the change in thoracolumbar kyphosis (TLK) from before to after surgery was significantly larger in the group with POI. Multivariate logistic regression analysis showed that male sex, LLIF and large changes in TLK from before to after surgery were significantly associated with the development of POI.

Conclusions: These results suggested that LLIF and large corrections in TLK were independent risk factors for POI after ASD surgery. When patients with ASD have large TLK preoperatively, and it is determined that a large correction is needed, physicians must be aware of the potential for occurrence of POI.

Keywords: adult spinal deformity; lateral lumbar interbody fusion; perioperative complications; postoperative ileus; surgical spinal correction; thoracolumbar kyphosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Comparison of the frequency of non-POI complications between the POI (+) and POI (−) groups. POI; postoperative ileus.
See this image and copyright information in PMC

References

    1. Park HY, Ha KY, Kim YH, et al. Minimally invasive lateral lumbar interbody fusion for adult spinal deformity: clinical and radiological efficacy with minimum two years follow-up. Spine (Phila Pa 1976). 2018;43(14):E813–E821. doi:10.1097/brs.0000000000002507 - PubMed
    1. Ohba T, Ebata S, Oba H, Koyama K, Yokomichi H, Haro H. Predictors of poor global alignment and proportion score after surgery for adult spinal deformity. Spine (Phila Pa 1976). 2019;44(19):E1136–e1143. doi:10.1097/brs.0000000000003086 - PubMed
    1. Oba H, Ebata S, Takahashi J, et al. Loss of pelvic incidence correction after long fusion using iliac screws for adult spinal deformity: cause and effect on clinical outcome. Spine (Phila Pa 1976). 2018. doi:10.1097/brs.0000000000002775 - PubMed
    1. Tanaka N, Ebata S, Oda K, Oba H, Haro H, Ohba T. Predictors and clinical importance of postoperative coronal malalignment after surgery to correct adult spinal deformity. Clin Spine Surg. 2020;33(7):E337–E341. doi:10.1097/bsd.0000000000000947 - PubMed
    1. Soroceanu A, Burton DC, Oren JH, et al. Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact. Spine (Phila Pa 1976). 2016;41(22):1718–1723. doi:10.1097/BRS.0000000000001636 - PubMed

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