Postoperative pulmonary complications following posterior spinal instrumentation and fusion for congenital scoliosis

Abstract

BackgroundCongenital scoliosis (CS) may lead to more serious pulmonary complications compared with idiopathic scoliosis after spinal fusion surgery. However, little has been reported about postoperative pulmonary complication events in patients with CS after spinal fusion surgery.ObjectiveTo investigate the incidence of and predictive factors of postoperative pulmonary complications following posterior spinal instrumentation and fusion surgery for the treatment of CS.MethodsWe retrospectively reviewed the records of 174 patients with CS (128 females and 46 males, mean age 16.4 years) treated with posterior spinal instrumentation and fusion surgery between January 2012 and April 2017. We extracted demographic, medical history, and clinical data, and investigated the major predictive factors for postoperative pulmonary complications by logistic regression and receiver-operating characteristic curves analyses.ResultsA total of 26 (14.9%) patients developed postoperative pulmonary complications, consisting of pleural effusion (10.9%), pneumonia (6.9%), pneumothorax (1.1%), atelectasis (2.3%), hypoxemia (6.3%), and respiratory failure (1.1%). Logistic regression analysis revealed that the predictive factors for postoperative pulmonary complications were age > 18.1 years (P = 0.039), a Cobb angle of > 77° (P = 0.011), operation time of > 430 min (P = 0.032), and blood transfusion volume > 1500 ml (P = 0.015).ConclusionsPostoperative pulmonary complications are among the main complications following posterior spinal instrumentation and fusion surgery in patients with CS. Such patients aged >18.1 years, with Cobb angles > 77°, operation times > 430 min, and/or blood transfusion volume of > 1500 ml may be more likely to develop postoperative pulmonary complications.

Postoperative Pulmonary Complications in Complex Pediatric and Adult Spine Deformity: A Retrospective Review of Consecutive Patients Treated at a Single Site in West Africa

“…[7][8][9][10] The cumulative incidence of pulmonary complications after spine surgery has ranged from 0.6% to 14.9%. 2,[7][8][9]11,12 The differences in incidence may be attributable to the variations in the definition of pulmonary events in the various studies, the underlying etiologies, and surgical complexities. 2,[7][8][9][10][11][12] Higher rates of pulmonary complication have been reported for neuromuscular patient populations.…”

“…2,[7][8][9]11,12 The differences in incidence may be attributable to the variations in the definition of pulmonary events in the various studies, the underlying etiologies, and surgical complexities. 2,[7][8][9][10][11][12] Higher rates of pulmonary complication have been reported for neuromuscular patient populations. 10 The concern for pulmonary complications is even greater in underserved regions with limited expertise and resources.…”

Risk factors for pulmonary complications after posterior spinal instrumentation and fusion in the treatment of congenital scoliosis: a case-control study

“…However, little has been reported about postoperative pulmonary complication in CS patients. Yin et al recently investigated the pulmonary complication in CS patients, but the sample size of their study was small and the observation variables were inadequate [11]. Therefore, we conducted this retrospective study to describe the morbidity and further try to find the risk factors of postoperative pulmonary complications after posterior spinal instrumentation and fusion surgery in CS patients.…”

Risk factors for postoperative pulmonary complications in children with severely compromised pulmonary function secondary to severe scoliosis

“…Some differences in these markers were identified, for example in our group the Cobb angle cut‐off was >90° whereas Kang et al 18 found a relationship with Cobb angle >69°, although all their patients had neuromuscular diseases. Recently, Yin et al 3 reported a cobb angle of >77° as a predicted factor for postoperative pulmonary complication. This difference in Cobb angle value could mainly be due to the fact that the majority of our subjects had Idiopathic scoliosis.…”