Susana Núñez-Pereira1,2, Ferran Pellisé3,4, Alba Vila-Casademunt3, Ahmet Alanay5, Emre Acaraglou6, Ibrahim Obeid7, Francisco Javier Sánchez Pérez-Grueso8, Frank Kleinstück9. 1. Spine Research Unit, Vall D'Hebron Research Institute, Barcelona, Spain. snunezpereira@gmail.com. 2. Department of Orhtopaedics and Traumatology, Hospital Universitario Donostia, Servicio de Cirugía Ortopédica Y Traumatología, Paseo del Dr Begiristain 110, 20014, Donostia/San Sebastián, Spain. snunezpereira@gmail.com. 3. Spine Research Unit, Vall D'Hebron Research Institute, Barcelona, Spain. 4. Spine Surgery Unit, Vall d'Hebron University Hospital, Barcelona, Spain. 5. Department of Orthopaedics and Traumatology, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey. 6. Ankara ARTES Spine Center, Ankara, Turkey. 7. Spine Surgery Unit, Bordeaux University Hospital, Bordeaux, France. 8. Spine Surgery Unit, Hospital La Paz, Madrid, Spain. 9. Spine Center Division, Schulthess Klinik, Zurich, Switzerland.
Abstract
PURPOSE: Major complications are a concern following ASD surgery. Even when properly managed and resolved, they may still have a relevant impact on HRQL. We aimed to investigate the impact of resolved early major complications on 2-year outcome after ASD surgery. METHODS: Two groups of consecutive surgical patients were extracted from a prospective multicentre database. Major complication group (MCG) included patients with any major complication, resolved within 6 months after surgery. Patients with further major complications during follow-up were excluded. Control group (CG) included patients with no major complications over the entire follow-up. Analysis of covariance adjusting for preoperative baseline values was used to compare improvements in HRQL measures at 2 years. RESULTS: One hundred and seventy-five patients met the inclusion criteria and had complete HRQL data at 2 years (24 MCG, 151 CG). MCG patients were older and had more severe deformity and poorer baseline HRQL. There were 27 resolved major complications at 6 months needing 19 additional surgeries (18 revisions, 1 cholecystectomy). At 2 years, and after adjusting for preoperative data, outcome in MCG patients was as follows: scores were 5.98 (SE 3.03) points higher for the ODI (p = 0.05), 0.36 (SE 0.13) lower SRS-22 function (p = 0.01), 4.07 (SE 1.93) lower SF-36 PCS (p = 0.04), and 0.16 (SE 0.13) lower SRS-22 subtotal (p = 0.22). CONCLUSION: The results indicate that patients experiencing major complications after ASD surgery have significantly less functional improvement (SRS-22 function, ODI, SF-36 PCS) than their complication-free counterparts, even when complications were considered resolved, and the outcome was measured after an 18-month complication-free period. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: Major complications are a concern following ASD surgery. Even when properly managed and resolved, they may still have a relevant impact on HRQL. We aimed to investigate the impact of resolved early major complications on 2-year outcome after ASD surgery. METHODS: Two groups of consecutive surgical patients were extracted from a prospective multicentre database. Major complication group (MCG) included patients with any major complication, resolved within 6 months after surgery. Patients with further major complications during follow-up were excluded. Control group (CG) included patients with no major complications over the entire follow-up. Analysis of covariance adjusting for preoperative baseline values was used to compare improvements in HRQL measures at 2 years. RESULTS: One hundred and seventy-five patients met the inclusion criteria and had complete HRQL data at 2 years (24 MCG, 151 CG). MCG patients were older and had more severe deformity and poorer baseline HRQL. There were 27 resolved major complications at 6 months needing 19 additional surgeries (18 revisions, 1 cholecystectomy). At 2 years, and after adjusting for preoperative data, outcome in MCG patients was as follows: scores were 5.98 (SE 3.03) points higher for the ODI (p = 0.05), 0.36 (SE 0.13) lower SRS-22 function (p = 0.01), 4.07 (SE 1.93) lower SF-36 PCS (p = 0.04), and 0.16 (SE 0.13) lower SRS-22 subtotal (p = 0.22). CONCLUSION: The results indicate that patients experiencing major complications after ASD surgery have significantly less functional improvement (SRS-22 function, ODI, SF-36 PCS) than their complication-free counterparts, even when complications were considered resolved, and the outcome was measured after an 18-month complication-free period. These slides can be retrieved under Electronic Supplementary Material.
Authors: Joshua D Auerbach; Lawrence G Lenke; Keith H Bridwell; Jennifer K Sehn; Andrew H Milby; David Bumpass; Charles H Crawford; Brian A OʼShaughnessy; Jacob M Buchowski; Michael S Chang; Lukas P Zebala; Brenda A Sides Journal: Spine (Phila Pa 1976) Date: 2012-06-15 Impact factor: 3.468
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Authors: Anne F Mannion; Tamas F Fekete; David O'Riordan; François Porchet; Urs M Mutter; Dezsö Jeszenszky; Friederike Lattig; Dieter Grob; Frank S Kleinstueck Journal: Spine J Date: 2013-03-21 Impact factor: 4.166
Authors: Steven D Glassman; Christopher L Hamill; Keith H Bridwell; Frank J Schwab; John R Dimar; Thomas G Lowe Journal: Spine (Phila Pa 1976) Date: 2007-11-15 Impact factor: 3.468
Authors: Justin K Scheer; Jessica A Tang; Justin S Smith; Eric Klineberg; Robert A Hart; Gregory M Mundis; Douglas C Burton; Richard Hostin; Michael F O'Brien; Shay Bess; Khaled M Kebaish; Vedat Deviren; Virginie Lafage; Frank Schwab; Christopher I Shaffrey; Christopher P Ames Journal: J Neurosurg Spine Date: 2013-08-23