Review Question - QID 4437

Studies have shown major complications occur in 10% of patients that undergo adult spinal deformity surgery.

Major complications are reported in approximately 10% of pateints undergoing adult spinal deformity surgery. Many of these major complications, such as neurologic deficits, cardiac events, and thromboembolic events are irreversible and adversely affect the long term health of the patient. Patients undergoing adult spinal deformity should have a thorough understanding of the risks prior to proceeding with surgery.

Glassman et al. looked at patients undergoing adult spinal deformity surgery and found forty-seven major complications were reported in 46 patients. Sixty-two minor complications were noted in 46 patients. They found major complications adversely affected the SF-12 general health scores at 1 year after surgery. The most common major complication found at follow up was instrumentation failure.

Piasecki et al. looked at the rate of thormboembolic disease (TED) in 66 consecutive adult patients who underwent extensive anterior/posterior spinal reconstructions for spinal deformity. They found the total incidence of postoperative TED was 13.6%. The overall rate of DVT was 9.1%, one-third occurring in the pelvis. PE developed in 7.6%. Right-sided thoracoabdominal approaches were associated with an increased risk of developing DVT, PE, and TED.

Sansur et al. queried the Scoliosis Research Society (SRS) morbidity and mortality database from 2004 to 2007. Complications were identified and analyzed on the basis of patient characteristic and surgical techniques. They found the overall complication rate for AS treatment is 13.4%, and that the complication rate is significantly higher when osteotomies, revision procedures, and combined anterior/posterior approaches are used. Complication rate was not influenced by scoliosis type or age.

Illustration A shows the frequency of intraoperative, perioperative, and follow-up complications from the Glassman et al. study.