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
. 2022 Aug 23;12(1):14350.
doi: 10.1038/s41598-022-18417-z.

Analysis of risk factors for perioperative complications in spine surgery

Nicole Lange  1 , Thomas Stadtmüller  2 , Stefanie Scheibel  2 , Gerda Reischer  2 , Arthur Wagner  2 , Bernhard Meyer  2 , Jens Gempt  2
Affiliations

Analysis of risk factors for perioperative complications in spine surgery

Nicole Lange et al. Sci Rep. .

Abstract

Complications in spine surgery can arise in the intraoperative or the immediate postoperative period or in a delayed manner. These complications may lead to severe or even permanent morbidity if left undiagnosed and untreated. We prospectively interviewed 526 patients out of 1140 patients who consecutively underwent spinal surgery in our department between November 2017 and November 2018 and analysed the outcome and complication rates. A 12 months follow-up period was also adopted. We analysed the patients' clinical characteristics, comorbidities, surgical management, survival rates, and outcomes. Risk factor analyses for the development of complications were also performed. Patients' median age was 67 years (range: 13-96). The main diagnoses were as follows: degenerative in 50%, tumour in 22%, traumatic fractures in 13%, infections in 10%, reoperations in 3%, and others in 2%. Surgeries were emergency procedures (within 24 h) in 12%. Furthermore, 59% required instrumentation. The overall postoperative complication rate was 26%. Revision surgery was required in 12% of cases within 30 postoperative days (median time to revision 11 days [IQR 5-15 days]). The most frequent complications included wound healing disorders, re-bleeding, and CSF leakage. Thereby, the risk factor analysis revealed age-adjusted CCI (p = 0.01), metastatic tumour (p = 0.01), and atrial fibrillation (p = 0.02) as significant risk factors for postoperative complications. Additionally, postoperative KPS (p = 0.004), postoperative anaemia (p = 0.001), the length of hospital stay (p = 0.02), and duration of surgery (p = 00.002) were also identified as associated factors. Complication rates after spinal surgeries are still high, especially in patients with metastatic tumour disease and poor clinical status (KPS), requiring revision surgeries in several cases. Therefore, specific risk factors should be determined to carefully select surgery groups.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart showing patient inclusion and exclusion throughout the study.
Figure 2
Figure 2
Significant risk factors for complications during patients’ hospital stay.
See this image and copyright information in PMC

References

    1. Swann MC, Hoes KS, Aoun SG, McDonagh DL. Postoperative complications of spine surgery. Best Pract. Res. Clin. Anaesthesiol. 2016;30:103–120. doi: 10.1016/j.bpa.2016.01.002. - DOI - PubMed
    1. Hemmer C. Surgical complications associated with cervical spine surgery. Orthop. Nurs. 2018;37:348–354. doi: 10.1097/nor.0000000000000498. - DOI - PubMed
    1. Guerin P, et al. Incidental durotomy during spine surgery: Incidence, management and complications. A retrospective review. Injury. 2012;43:397–401. doi: 10.1016/j.injury.2010.12.014. - DOI - PubMed
    1. Akins PT, et al. Risk factors associated with 30-day readmissions after instrumented spine surgery in 14,939 patients. Spine. 2015;40:1022–1032. doi: 10.1097/brs.0000000000000916. - DOI - PubMed
    1. Lee MJ, et al. Risk factors for medical complication after spine surgery: A multivariate analysis of 1,591 patients. Spine J. 2012;12:197–206. doi: 10.1016/j.spinee.2011.11.008. - DOI - PMC - PubMed

Publication types