Andrea Zanirato1, Marco Damilano2, Matteo Formica1, Andrea Piazzolla3, Alessio Lovi2, Jorge Hugo Villafañe4, Pedro Berjano2. 1. Clinica Ortopedica, IRCCS AOU SAN MARTINO IST, Genoa, Italy. 2. IRCCS Istituto Ortopedico Galeazzi, Milan, Italy. 3. U.O.C. Ortopedia e Traumatologia Universitaria, Azienda Ospedaliero Universitaria Policlinico di Bari, Bari, Italy. 4. IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy. mail@villafane.it.
Abstract
PURPOSE: To review the incidence of perioperative and late complications of surgery for spinal deformity (ASD). METHODS: Review of the literature. We reviewed recent literature in English to investigate the incidence of complications in ASD surgery in the perioperative (≤ 3 months post-operative) and late (> 3 months post-operative) periods. Randomized-controlled trials, non-randomized trials, cohort studies, case-control studies, and case series published in 2005 or later were included. We divided articles according to surgical technique: open procedures (OP), minimally invasive surgery (MIS), and hybrid procedures (HP). Complications were recorded, grouped by surgical technique, and then classified according to a proposed Grading of Incidence of Complications (IOC). RESULTS: Ninety-six publications reporting on 12,168 patients were included; 68 were level IV of evidence studies, 24 were level III, and 4 level II. Perioperative IOC was 26.5% in OP, 36.4% in HP, and 24.2% in MIS. Late IOC was 11.1% in OP, 15.4% in HP, and 14.0% in MIS. IOC was significantly higher for hybrid procedures compared to both open and MIS procedures. CONCLUSIONS: Reported complications of surgery for ASD in the recent literature are frequent (24-36% perioperative plus 11-15% late). Open procedures were the most extensively reported in the literature. Complication rates are similar for OP and MIS. HP presented higher IOC likely due to the combination of OP and MIS respective complications. Small number of studies and heterogeneity in reporting could result in risk of bias in these results. Large-scale registry-based studies can fill this gap in the future. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: To review the incidence of perioperative and late complications of surgery for spinal deformity (ASD). METHODS: Review of the literature. We reviewed recent literature in English to investigate the incidence of complications in ASD surgery in the perioperative (≤ 3 months post-operative) and late (> 3 months post-operative) periods. Randomized-controlled trials, non-randomized trials, cohort studies, case-control studies, and case series published in 2005 or later were included. We divided articles according to surgical technique: open procedures (OP), minimally invasive surgery (MIS), and hybrid procedures (HP). Complications were recorded, grouped by surgical technique, and then classified according to a proposed Grading of Incidence of Complications (IOC). RESULTS: Ninety-six publications reporting on 12,168 patients were included; 68 were level IV of evidence studies, 24 were level III, and 4 level II. Perioperative IOC was 26.5% in OP, 36.4% in HP, and 24.2% in MIS. Late IOC was 11.1% in OP, 15.4% in HP, and 14.0% in MIS. IOC was significantly higher for hybrid procedures compared to both open and MIS procedures. CONCLUSIONS: Reported complications of surgery for ASD in the recent literature are frequent (24-36% perioperative plus 11-15% late). Open procedures were the most extensively reported in the literature. Complication rates are similar for OP and MIS. HP presented higher IOC likely due to the combination of OP and MIS respective complications. Small number of studies and heterogeneity in reporting could result in risk of bias in these results. Large-scale registry-based studies can fill this gap in the future. These slides can be retrieved under Electronic Supplementary Material.
Authors: D Kojo Hamilton; Adam S Kanter; Bryan D Bolinger; Gregory M Mundis; Stacie Nguyen; Praveen V Mummaneni; Neel Anand; Richard G Fessler; Peter G Passias; Paul Park; Frank La Marca; Juan S Uribe; Michael Y Wang; Behrooz A Akbarnia; Christopher I Shaffrey; David O Okonkwo Journal: Eur Spine J Date: 2016-02-24 Impact factor: 3.134
Authors: Yongjung J Kim; Keith H Bridwell; Lawrence G Lenke; Gene Cheh; Christine Baldus Journal: Spine (Phila Pa 1976) Date: 2007-09-15 Impact factor: 3.468
Authors: Peter S Rose; Lawrence G Lenke; Keith H Bridwell; Daniel S Mulconrey; Geoffrey A Cronen; Jacob M Buchowski; Richard M Schwend; Brenda A Sides Journal: Spine (Phila Pa 1976) Date: 2009-04-15 Impact factor: 3.468
Authors: Francesco Langella; Paolo Barletta; Alice Baroncini; Matteo Agarossi; Laura Scaramuzzo; Andrea Luca; Roberto Bassani; Giuseppe M Peretti; Claudio Lamartina; Jorge H Villafañe; Pedro Berjano Journal: Eur Spine J Date: 2021-05-10 Impact factor: 3.134
Authors: Pedro Berjano; Ming Xu; Marco Damilano; Thomas Scholl; Claudio Lamartina; Michael Jekir; Fabio Galbusera Journal: Eur Spine J Date: 2019-05-25 Impact factor: 3.134
Authors: Philipp Poppenborg; Ulf Liljenqvist; Georg Gosheger; Albert Schulze Boevingloh; Lukas Lampe; Sebastian Schmeil; Tobias L Schulte; Tobias Lange Journal: Eur Spine J Date: 2020-12-22 Impact factor: 3.134
Authors: M Formica; E Quarto; A Zanirato; L Mosconi; M Lontaro-Baracchini; M Alessio-Mazzola; L Felli Journal: Eur Spine J Date: 2020-09-15 Impact factor: 3.134