Kenny Yat Hong Kwan1, Cora Bow1, Dino Samartzis2, Lawrence G Lenke3, Christopher I Shaffrey4, Leah Y Carreon5, Benny T Dahl6,7, Michael G Fehlings8, Christopher P Ames9, Oheneba Boachie-Adjei10, Mark B Dekutoski11, Khaled M Kebaish12, Stephen J Lewis8, Yukihiro Matsuyama13, Hossein Mehdian14, Ferran Pellisé15, Yong Qiu16, Frank J Schwab17, Kenneth Man Chee Cheung18. 1. Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong. 2. Rush University Medical Centre, Chicago, IL, USA. 3. Columbia University Medical Center, New York, NY, USA. 4. University of Virginia Medical Center, Charlottesville, VA, USA. 5. Norton Leatherman Spine Center, Louisville, KY, USA. 6. Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 7. Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA. 8. University of Toronto and Toronto Western Hospital, Toronto, ON, Canada. 9. University of California San Francisco, San Francisco, CA, USA. 10. The FOCOS Hospital, Pantang West, Republic of Ghana. 11. Marshfield Clinic Eau Claire Center, Eau Claire, WI, USA. 12. Johns Hopkins University, Baltimore, MD, USA. 13. Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan. 14. Queen's Medical Centre, University Hospital, Nottingham, UK. 15. Hospital Universitari Vall d'Hebron, Barcelona, Spain. 16. Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China. 17. Hospital for Special Surgery, New York, NY, USA. 18. Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F Professorial Block, Queen Mary Hospital, 102 Pokfulam Road, Pokfulam, Hong Kong. cheungmc@hku.hk.
Abstract
PURPOSE: Accurate information regarding the expected complications of complex adult spinal deformity (ASD) is important for shared decision making and informed consent. The purpose of the present study was to investigate the rate and types of non-neurologic adverse events after complex ASD surgeries, and to identify risk factors that affect their occurrence. METHODS: The details and occurrence of all non-neurologic adverse events were reviewed in a prospective cohort of 272 patients after complex ASD surgical correction in a mulitcentre database of the Scoli-RISK-1 study with a planned follow-up of 2 years. Logistic regression analyses were used to identify potential risk factors for non-neurologic adverse events. RESULTS: Of the 272 patients, 184 experienced a total of 515 non-neurologic adverse events for an incidence of 67.6%. 121 (44.5%) patients suffered from more than one adverse event. The most frequent non-neurologic adverse events were surgically related (27.6%), of which implant failure and dural tear were most common. In the unadjusted analyses, significant factors for non-neurologic adverse events were age, previous spine surgery performed, number of documented non-neurologic comorbidities and ASA grade. On multivariable logistic regression analysis, previous spine surgery was the only independent risk factor for non-neurologic adverse events. CONCLUSIONS: The incidence of non-neurologic adverse events for patients undergoing corrective surgeries for ASD was 67.6%. Previous spinal surgery was the only independent risk factor predicting the occurrence of non-neurologic adverse events. These findings complement the earlier report of neurologic complications after ASD surgeries from the Scoli-RISK-1 study. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: Accurate information regarding the expected complications of complex adult spinal deformity (ASD) is important for shared decision making and informed consent. The purpose of the present study was to investigate the rate and types of non-neurologic adverse events after complex ASD surgeries, and to identify risk factors that affect their occurrence. METHODS: The details and occurrence of all non-neurologic adverse events were reviewed in a prospective cohort of 272 patients after complex ASD surgical correction in a mulitcentre database of the Scoli-RISK-1 study with a planned follow-up of 2 years. Logistic regression analyses were used to identify potential risk factors for non-neurologic adverse events. RESULTS: Of the 272 patients, 184 experienced a total of 515 non-neurologic adverse events for an incidence of 67.6%. 121 (44.5%) patients suffered from more than one adverse event. The most frequent non-neurologic adverse events were surgically related (27.6%), of which implant failure and dural tear were most common. In the unadjusted analyses, significant factors for non-neurologic adverse events were age, previous spine surgery performed, number of documented non-neurologic comorbidities and ASA grade. On multivariable logistic regression analysis, previous spine surgery was the only independent risk factor for non-neurologic adverse events. CONCLUSIONS: The incidence of non-neurologic adverse events for patients undergoing corrective surgeries for ASD was 67.6%. Previous spinal surgery was the only independent risk factor predicting the occurrence of non-neurologic adverse events. These findings complement the earlier report of neurologic complications after ASD surgeries from the Scoli-RISK-1 study. These slides can be retrieved under Electronic Supplementary Material.
Authors: Meghan Cerpa; Lawrence G Lenke; Michael G Fehlings; Christopher I Shaffrey; Kenneth M C Cheung; Leah Yacat Carreon Journal: Global Spine J Date: 2019-05-08
Authors: Kenny Yat Hong Kwan; Lawrence G Lenke; Christopher I Shaffrey; Leah Y Carreon; Benny T Dahl; Michael G Fehlings; Christopher P Ames; Oheneba Boachie-Adjei; Mark B Dekutoski; Khaled M Kebaish; Stephen J Lewis; Yukihiro Matsuyama; Hossein Mehdian; Yong Qiu; Frank J Schwab; Kenneth Man Chee Cheung Journal: Clin Orthop Relat Res Date: 2021-02-01 Impact factor: 4.755