Morbidity & Mortality Survey of Spinal Deformity Surgery in 2012-Report by the Japanese Scoliosis Society

Abstract

Introduction The Japanese Scoliosis Society (JSS) planned to make a longitudinal survey of the mortality and morbidity (M&M) of spinal deformity surgery and established the M&M Committee in 2012. We reported the analysis of the surgical complication (M&M) survey in 2012. Methods A request to participate in this survey was mailed to all JSS members. Questionnaires were sent by email to members who agreed to cooperate, and their answers were obtained. Diagnosis was grouped into idiopathic scoliosis, congenital scoliosis, neuromuscular scoliosis, spondylolisthesis, pediatric kyphosis, and adult spinal deformity. Complications were grouped into death, blindness, neurological deficit, infection, massive bleeding, hematoma, pneumonia, cardiac failure, DVT/PE, gastrointestinal perforation, and instrumentation failure. Results A total of 2,906 patients were reported from sixty-eight hospitals: idiopathic 488, congenital 91, neuromuscular 82, others 214, spondylolisthesis 1,241, pediatric kyphosis 41, and adult spinal deformity 749. Complications were death in 3, neurological deficit in 49, early infection in 37, late infection in 14, massive bleeding in 91, hematoma in 18, pneumonia in 6, cardiac failure in 1, DVT/PE in 9, gastrointestinal perforation in 2, and instrumentation failure in 73. The complication rate of having a neurological deficit, massive bleeding, and instrumentation failure was 4.88%, 7.32%, and 4.88% respectively in patients with pediatric kyphosis, and 3.07%, 8.01%, and 5.21% respectively in patients with an adult spinal deformity. The complication rate of early infection was 4.88% in the patients with pediatric kyphosis. Conclusions The complication rates of pediatric kyphosis and adult spinal deformity were high.

Risk Factors for Postoperative Ileus after Scoliosis Surgery

“…Complications of this surgery are common and may be very serious. Several complications have been reported after scoliosis surgery, including infection, pneumonia, urinary tract infection, Clostridium difficile infection, sepsis, stroke, delirium, deep venous thrombosis, pulmonary embolism, myocardial infarction, arrhythmia, congestive heart failure, pneumothorax, atelectasis, adult respiratory distress syndrome, bowel obstruction, and renal failure 1,4,5) . POI is also a reported complication, although it is regarded as an early and minor complication following spine surgery.…”

“…Scoliosis surgery is increasingly common, and the occurrence of associated postoperative complications has accordingly risen 1) . Some reports have described postoperative superior mesenteric artery (SMA) syndrome following scoliosis surgery 2,3) , but few have described postoperative ileus (POI).…”

Unusual cause of hemoptysis: A case report

“…The complexity of spinal surgery is reflected in the diversity of complications that maight occur months or years later [ 8 , 16 ]. Spinal rod migration happens rarely, and among the reasons mentioned are repetitive fatigue or minor trauma [ 9 ], fatigue-fracture of the rod secondary to motion in the setting of nonunion of fusion attempts [ 14 ], or progressive kyphosis [ 15 ].…”

Perioperative outcome and complications following single-staged Posterior Spinal Fusion (PSF) using pedicle screw instrumentation in Adolescent Idiopathic Scoliosis (AIS): a review of 1057 cases from a single centre

“…These perioperative complications include intraoperative blood loss, neurological deficit, infection, vision loss and death [ 3 ], with excessive blood loss being one of the commonest as reported by Carreon et al [ 4 ] Risks of perioperative complications such as massive haemorrhage requiring use of allogeneic blood transfusion were higher in patients with severe scoliosis [ 5 , 6 ], prolonged duration of surgery and usage of combined anterior-posterior approach or when spinal osteotomies were performed [ 7 – 9 ]. The prevalence of neurologic complications ranged from 0.3 to 2.6% [ 10 , 11 ], whereas non-neurologic complications ranged from 0 to 7.7% [ 12 , 13 ]. The overall complication rate for posterior spinal fusion (PSF) ranged from 1.4 to 5.2% [ 13 , 14 ].…”