Prospective Evaluation of Complication Rates Associated with Adult Spinal Deformity Surgery

J Neurosurg Spine 25:1-14, 2016

Adult spinal deformity (ASD) surgery significantly improved quality of life compared to non-operative management at 2 years follow-up in a multicenter study. Researchers prospectively evaluated complication rates in 291 patients with a mean age of 56.2 years who achieved a minimum of 2 years follow-up. Complications were classified as major/minor and as perioperative (within 6 weeks of surgery) or delayed (between 6 weeks and time of last follow-up) with standardized data forms. Surgeries included posterior (99%), anterior (25%), and 3-column osteotomy (19%) procedures. 28.2% of patients required at least one revision procedure. For 469 total complications, 262 major complications (125 perioperative and 137 delayed) were recorded with 69.8% of patients affected. Older age (p = 0.009), greater body mass index (p ≤ 0.031), increased co-morbidities (p ≤ 0.007), previous spine fusion (p = 0.029), and 3-column osteotomies (p = 0.036) were all associated with higher complication rates. 2-year follow-up was not achieved in 2 patients due to perioperative mortality (pulmonary embolus and inferior vena cava injury). This study provides a comprehensive evaluation of ASD surgery-associated perioperative and delayed complications. 

H. Francis Farhadi, MD, PhD
Columbus, OH