Arun R Hariharan1, Suken A Shah2, Joseph Petfield3, Margaret Baldwin4, Burt Yaszay5, Peter O Newton6, Lawrence G Lenke7, Baron S Lonner8, Firoz Miyanji9, Paul D Sponseller10, Amer F Samdani11. 1. Pediatric Orthopedics of Southwest Florida, Fort Myers, FL, USA. 2. Department of Orthopaedics, Nemours Children's Hospital, Delaware, 1600 Rockland Road, Wilmington, DE, 19803, USA. sshah@nemours.org. 3. Penn State College of Medicine, Hershey, PA, USA. 4. Nemours Children's Hospital, Florida, Orlando, FL, USA. 5. Seattle Children's Hospital, Seattle, WA, USA. 6. Rady Children's Hospital, San Diego, CA, USA. 7. Columbia University, New York, NY, USA. 8. Mount Sinai Hospital, New York, NY, USA. 9. BC Children's Hospital, Vancouver, BC, Canada. 10. Johns Hopkins Hospital, Baltimore, MD, USA. 11. Shriners Hospitals for Children, Philadelphia, Philadelphia, PA, USA.
Abstract
BACKGROUND: Accurate reporting of long-term complications of surgical treatment of adolescent idiopathic scoliosis (AIS) is critical, but incomplete. This study aimed to report on the rate of complications following surgical treatment of AIS among patients with at least 10 years of follow-up. METHODS: This was a retrospective review of prospectively collected data from a multicenter registry of patients who underwent surgical treatment for AIS with minimum 10-year follow-up. Previously published complications were defined as major if they resulted in reoperation, prolonged hospital stay/readmission, neurological deficits, or were considered life-threatening. Rates and causes of reoperations were also reviewed. RESULTS: Two hundred and eighty-two patients were identified with mean age at surgery of 14.6 ± 2.1 years. Mean follow-up was 10.6 (range 9.5-14) years. Eighty-seven patients had anterior spinal fusion (ASF); 195 had posterior spinal fusion (PSF). The overall major complication rate was 9.9% (n = 28) in 27 patients. Among PSF patients, the complication rate was 9.7% (n = 19) in 18 patients. The complications were surgical site infection (37%), adding-on (26%), pulmonary (16%), neurologic (11%), instrumentation (5%), and gastrointestinal (5%). In ASF patients, the complication rate was 10.3% (n = 9) among nine patients. The complications were pulmonary (44%), pseudoarthrosis (22%), neurologic (11%), adding-on (11%), and gastrointestinal (11%). The reoperation rate was 6.0% (n = 17) among 17 patients. Although most of the complications presented within the first 2 years (60.7%), surgical site infection and adding-on were also seen late into the 10-year period. CONCLUSION: This is the largest prospective study with at least a 10-year follow-up of complications following spinal fusion for AIS, the overall major complication rate was 9.9% with a reoperation rate of 6.0%. Complications presented throughout the 10-year period, making long-term follow-up very important for surveillance. LEVEL OF EVIDENCE: Therapeutic II.
BACKGROUND: Accurate reporting of long-term complications of surgical treatment of adolescent idiopathic scoliosis (AIS) is critical, but incomplete. This study aimed to report on the rate of complications following surgical treatment of AIS among patients with at least 10 years of follow-up. METHODS: This was a retrospective review of prospectively collected data from a multicenter registry of patients who underwent surgical treatment for AIS with minimum 10-year follow-up. Previously published complications were defined as major if they resulted in reoperation, prolonged hospital stay/readmission, neurological deficits, or were considered life-threatening. Rates and causes of reoperations were also reviewed. RESULTS: Two hundred and eighty-two patients were identified with mean age at surgery of 14.6 ± 2.1 years. Mean follow-up was 10.6 (range 9.5-14) years. Eighty-seven patients had anterior spinal fusion (ASF); 195 had posterior spinal fusion (PSF). The overall major complication rate was 9.9% (n = 28) in 27 patients. Among PSF patients, the complication rate was 9.7% (n = 19) in 18 patients. The complications were surgical site infection (37%), adding-on (26%), pulmonary (16%), neurologic (11%), instrumentation (5%), and gastrointestinal (5%). In ASF patients, the complication rate was 10.3% (n = 9) among nine patients. The complications were pulmonary (44%), pseudoarthrosis (22%), neurologic (11%), adding-on (11%), and gastrointestinal (11%). The reoperation rate was 6.0% (n = 17) among 17 patients. Although most of the complications presented within the first 2 years (60.7%), surgical site infection and adding-on were also seen late into the 10-year period. CONCLUSION: This is the largest prospective study with at least a 10-year follow-up of complications following spinal fusion for AIS, the overall major complication rate was 9.9% with a reoperation rate of 6.0%. Complications presented throughout the 10-year period, making long-term follow-up very important for surveillance. LEVEL OF EVIDENCE: Therapeutic II.
Authors: Peter O Newton; Masayuki Ohashi; Tracey P Bastrom; Carrie E Bartley; Burt Yaszay; Michelle C Marks; Randal Betz; Lawrence G Lenke; David Clements Journal: Spine Deform Date: 2020-01-08
Authors: Stuart L Weinstein; Lori A Dolan; Kevin F Spratt; Kirk K Peterson; Mark J Spoonamore; Ignacio V Ponseti Journal: JAMA Date: 2003-02-05 Impact factor: 56.272
Authors: William F Lavelle; Andy A Beltran; Allen L Carl; Richard L Uhl; Khalid Hesham; Stephen A Albanese Journal: Scoliosis Spinal Disord Date: 2016-07-28