Peak Timing for Complications Following Adult Spinal Deformity Surgery.

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Peak Timing for Complications Following Adult Spinal Deformity Surgery.

World Neurosurg. 2018 Apr 21;:

Authors: Daniels AH, Bess S, Line B, Eltorai AEM, Reid DBC, Lafage V, Akbarnia BA, Ames CP, Boachie-Adjei O, Burton DC, Deviren V, Kim HJ, Hart RA, Kebaish KM, Klineberg EO, Gupta M, Mundis GM, Hostin RA, O'Brien M, Schwab FJ, Shaffrey CI, Smith JS, ISSG

Abstract
BACKGROUND: Overall complication rates for adult spinal deformity (ASD) surgery have been reported, however little data exists on the peak timing associated with specific complications. This study quantifies the peak timing for multiple complication types in an ASD cohort at minimum 2-year follow up.
METHODS: Multi-center, prospective analysis of all complications following ASD surgery in a consecutively enrolled cohort was performed. Inclusion criteria were ASD, age ≥ 18 years, spinal fusion ≥ 4 levels, and minimum 2-year follow-up. Complications included major and minor as well as specific complication types. Peak timing of specific complications were identified and described. Regression analysis was performed to assess correlation between patient/surgical factors and complication timing.
RESULTS: 280 patients met inclusion criteria. Mean follow-up time was 2.9 years (range 2-5 years). 209 (74.6%) patients had at least one complication accounting for 529 total complications (258 minor, 271 major). Both major and minor complications peaked at <3 months. Infection and neurologic complications peaked at <3 months. PJK had bimodal peaks at <3 and >24 months. Implant failure peaked at 12-24 and >24 months. There was a significant positive correlation between preoperative SVA and total complications at 6-12 months, major complications at 24-months, and reoperation. BMI was associated with total complications and implant failure at 12-24 and >24 months.
CONCLUSIONS: The peak timing of specific complications following ASD surgery are identifiable. Understanding when these complications are likely to occur may improve patient counseling, early diagnosis, and prophylactic interventions, and may help inform future reimbursement models.

PMID: 29689393 [PubMed - as supplied by publisher]

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