Daniel M Sciubba1, Alp Yurter2, Justin S Smith3, Michael P Kelly4, Justin K Scheer5, C Rory Goodwin2, Virginie Lafage6, Robert A Hart7, Shay Bess8, Khaled Kebaish9, Frank Schwab6, Christopher I Shaffrey3, Christopher P Ames10. 1. Department of Neurosurgery, The Johns Hopkins Hospital, 600 North Wolfe Street; Meyer Building, Room 7-109, Baltimore, MD 21287, USA. Electronic address: Dsciubb1@jhmi.edu. 2. Department of Neurosurgery, The Johns Hopkins Hospital, 600 North Wolfe Street; Meyer Building, Room 7-109, Baltimore, MD 21287, USA. 3. Department of Neurosurgery, University of Virginia Health System, 1215 Lee St, Charlottesville, VA 22903, USA. 4. Department of Orthopedic Surgery, Washington University, 4921 Parkview Place, A 12, St. Louis, MO 63110, USA. 5. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 2210, Chicago, IL 60611, USA. 6. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 306 E 15th Street, Suite 1F, New York, NY 10003, USA. 7. Department of Orthopaedic Surgery, Oregon Health & Science University, 3182 SW Sam Jackson Park Rd; Ortho Dept MC: OP31, Portland, OR 97239, USA. 8. Rocky Mountain Hospital for Children, 2055 High Street, Suite 130, Denver, CO 80205, USA. 9. Department of Orthopaedic Surgery, Johns Hopkins University, 610 North Caroline Street, Suite 5243, Baltimore, MD 21287, USA. 10. Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave, M779 - Department of Neurosurgery, San Francisco, CA 94143, USA.
Abstract
OBJECTIVE: An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. METHODS: A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). RESULTS: Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. CONCLUSIONS: A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.
OBJECTIVE: An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. METHODS: A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). RESULTS: Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. CONCLUSIONS: A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.
Authors: Andrea Zanirato; Marco Damilano; Matteo Formica; Andrea Piazzolla; Alessio Lovi; Jorge Hugo Villafañe; Pedro Berjano Journal: Eur Spine J Date: 2018-03-01 Impact factor: 3.134
Authors: Sleiman Haddad; Susana Núñez-Pereira; Carlos Pigrau; Dolors Rodríguez-Pardo; Alba Vila-Casademunt; Ahmet Alanay; Emre R Acaroglu; Frank S Kleinstueck; Ibrahim Obeid; Francisco Javier Sanchez Perez-Grueso; Ferran Pellisé Journal: Eur Spine J Date: 2018-05-04 Impact factor: 3.134