Perioperative complications after surgical treatment in degenerative adult de novo scoliosis

Abstract

BackgroundDegenerative adult de novo (DAD) scoliosis appears characteristically in the sixth or seventh decade with symptoms of severe back pain and radiculopathy or spinal claudication. The aim of this study was to enhance the knowledge of perioperative complications and detect possible risk factors in this selective DAD scoliosis surgery.MethodsThis retrospective study included only patients with DAD scoliosis undergone correction spondylodesis with previous failure of conservative treatment. Excluded were patients with other types of scoliosis and previous fusion surgeries. Patient epidemiological data, medical comorbidities and treatments were included. Intraoperative data and perioperative complications were documented. Analyses regarding early, late and no complications were undertaken.ResultsA total of 92 patients with a mean age of 67.29 ± 7.93 years and clinical follow-up visits of minimum 12 months were included. On average, 5.26 ± 2.24 segments were fused. Early complications (e.g. wound healing defects, paresis, screw loosing) occurred in 23 patients and often required a re-operation. Cardiac arrhythmias, pacemaker and coumarin derivative therapies were associated with increased perioperative complications. The transforaminal lumbar interbody fusion technique was associated with early complications. Adjacent segment failure occurred in 36% and was the major late complication. Twenty patients did not have any complications in the minimum follow-up.ConclusionsThis study analysed a selective DAD scoliosis collective and its’ surgical treatment outcomes. It identified numerous perioperative complications (adjacent segment failure, postoperative paresis and epidural hematoma) and multiple possible predisposing risk factors (e.g. operative techniques and anti-coagulation therapies). This here gained information raises awareness in preoperative patient selection and preparation. Further studies in DAD scoliosis and a risk-adjusted patient selection/preparation are needed to improve treatment quality and outcomes.

Assessment of the association between paraspinal muscle degeneration and quality of life in patients with degenerative lumbar scoliosis

“…PVMs have an important role in maintaining the stability of the spine. Degeneration of PVMs is associated with various lumbar diseases and post-operative complications (23,24). However, the pathogenesis of DLS remains to be elucidated.…”

Comparison of Transforaminal Lumbar Interbody Fusion Using the Boomerang-Shaped Cage with Traditional Posterior Lumbar Interbody Fusion for Lumbar Spondylolisthesis

“…Ad- CT and XP at 6 month postoperation ditionally, the cases were limited to a single-level fusion in our study. By comparing several level fusions, the benefits of TLIF would be emphasized, such as in elderly patients who require correction surgery for degenerative scoliosis using the multilevel interbody fusion that the low invasiveness of surgery including the decrease of blood loss and operative time would be essential to avoid the serious perioperative complication that affects the general condition 22,23) . The boomerang-shaped cages could be used for not only long fusion surgery but also minimally invasive surgery (MIS), which has recently been noticed as the new less invasive technique 24,25) .…”

Analysis of the Functional and Radiological Outcomes of Lumbar Decompression without Fusion in Patients with Degenerative Lumbar Scoliosis

“…Pseudoarthrosis is reported in around 5% of the patients, while adjacent segment disease was reported in almost 30% patients [27]. Implant-related complications in the early postoperative period are reported in about 9% of all patients [28]. Many recent reports have highlighted the increased association of post-junctional kyphosis with deformity correction in patients with degenerative lumbar scoliosis.…”