Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Spine Deformity Patients Undergoing Elective Spinal Fusion: A Single Institutional Study.

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Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Spine Deformity Patients Undergoing Elective Spinal Fusion: A Single Institutional Study.

World Neurosurg. 2017 Mar 27;:

Authors: Elsamadicy AA, Adogwa O, Warwick H, Sergesketter A, Lydon E, Shammas RL, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO

Abstract
BACKGROUND: Recent studies have reported that decompression with fusion leads to superior outcomes in the correction of spinal deformity. The aim of this study is to determine if there is a difference in intraoperative and 30-day postoperative complication rates in patients undergoing spinal fusion with and without decompression.
METHODS: The medical records of 874 adult (≥18 years old) spine deformity patients undergoing elective spinal fusion at a major academic institution from 2005 to 2015 were reviewed. We identified 374 (42.8%) who underwent a laminectomy in addition to the spinal fusion. The primary outcome investigated in this study was the rate of intraoperative and 30-day complications.
RESULTS: Patient demographics and comorbidities were similar between groups, Table 1. The laminectomy cohort had significantly higher EBL (p<0.0001), incidence of allogenic blood transfusions (p=0.0001), and higher rate of intraoperative durotomies (Laminectomy: 10.4% vs. No-Laminectomy: 3.1%, p<0.0001), Table 2. The laminectomy cohort had a significantly higher proportion of patients in the ICU (28.6% vs. 17.7%, p<0.001), Table 3. There was no significant difference in the rate 30-day readmissions between the cohorts (Laminectomy: 13.0% vs. No-Laminectomy: 9.8%, p=0.13), Table 4. Within 30 days after initial discharge, the laminectomy cohort had significantly higher rates of altered mental status (3.2% vs. 1.2%, p=0.05), UTI (4.3% vs. 1.4%, p=0.009), wound drainage (7.2% vs. 3.1%, p=0.007), and instrumentation failure (1.1% vs. 0.0%, p=0.03), Table 4.
CONCLUSION: Our study suggests that patients undergoing spinal fusion with laminectomy may have higher complication rates than patients undergoing spinal fusion alone.

PMID: 28359921 [PubMed - as supplied by publisher]

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