Introduction: Approximately 2% to 16% of patients undergoing spinal surgery suffer adverse events or complications. There is a paucity of studies evaluating the impact of complications on long-term outcomes. The purpose of this study was to assess the long-term effects of surgical complications on patient’s functional improvement and overall health status.
Methods: A multi-institutional, prospective spine outcomes registry was utilized. 1971 patients undergoing primary or revision lumbar fusion for low back pain and/or radiculopathy between January 2003 and December 2010 were enrolled. All patients completed the Oswestry Disability Index (ODI), MOS Short Form 36 (SF-36), and back- and leg-pain numerical rating scores before surgery, and at one-/two-years post-operative. Patients were stratified based on the occurrence of a peri-/post-operative complication, and by major versus minor complications. Baseline and 2-year clinical outcome scores were compared between cohorts.
Results: Both groups were similar at baseline (Table 1). Complications occurred in 159 (8.07%) patients. The most common complications were CSF leak (49.18%), bleeding requiring transfusion (13.11%) and nerve root injury (9.83%), Table 2. Compared to baseline, there was no significant difference in the extent of functional improvement (ODI, VAS, SF-36) between both patient groups, at one- and two-years post-operative, Tables 3&4. Furthermore, there was no significant difference in outcomes scores between patients with minor versus major complication, Figure 1.
Conclusions: Within the context of an on-going debate on the consequences of complications, we observed no lasting effect of complications on the patient’s interpretation of overall health status and functional improvement at one- and two-years following elective lumbar spine surgery
Patient Care: Physicians should inform patients of complications during surgery as this does not negatively affect patient's interpretation of their health status
Learning Objectives: The incidence of surgical complication does not affect patient's interpretation of health status