Introduction: Movement disorders are frequently associated with spinal deformity. The exact influence of these conditions on perioperative complications has not been rigorously evaluated.
Methods: This is a retrospective analysis of patients treated by single surgeon (CIS) from 2003 to 2010 for spinal deformity correction with documented movement disorders.
Results: Fourteen patients underwent 23 spinal deformity correction procedures. One patient underwent four procedures, 2 underwent 2 each and 2 underwent 3 each. The average age was 67 +/- 7 years. Ten were male and 4 female. The average ASA was 3 (min 2 / max 4). The average estimated blood loss was 1741 mL +/- 1404. Sixteen of the 23 cases were revision procedures (70%). Twelve patients were diagnosed with Parkinson’s disease, 1 with dystonia and 1 with essential tremor. Eleven patients were on dopaminergic therapy and three patients had deep brain stimulators placed prior to their first operation. Twelve of the patients underwent procedures for correction of thoracolumbar degenerative scoliosis and two for cervical myelopathy. The most common indication for revision was proximal junctional failure and implant complications or failure.
Complications occurred with 15/23 procedures (65%) with 36 overall. There were two mortalities (14%). The most common complications included 5 arrthymias (most commonly atrial fibrillation) and 4 venous thromboembolism (3 DVT and 1 PE). Of note thirteen complications occurred in one patient. See Table 1 for a complete list of complications.
Conclusions: There is a high incidence of perioperative complications related to spinal deformity correction in patients with movement disorders. They should be counseled regarding these risks preoperatively and thorough preoperative screening should be performed to mitigate their occurrence.
Patient Care: Improved counseling for patients with movement disorders undergoing spinal deformity correction.
Learning Objectives: Improve the understanding of the incidence and type of complications occurring with spinal deformity correction and movement disorders.