Risk factors for medical complications after long-level internal fixation in the treatment of adult degenerative scoliosis

Zhang, Xinuo; Sun, Xiangyao; Meng, Xianglong; Hai, Yong

doi:10.1007/s00264-018-3927-6

Cited by 13 publications

(15 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Owing to the fact that most of our patients were relatively young, there was relatively little data on history of lumbar operation, previous medication use, or whether there were any ageassociated comorbidities such as diabetes and osteoporosis, some of which could be potential risk factors for ADS. Several studies have reported a direct correlation between parameters such as the ASA grade, Cobb angle, total operation time, PT, level of fusion, LOS, staging, multiple surgeries and the incidence of perioperative complications in ADS [9,[19][20][21][22]. However, further research is needed to identify the risk factors for perioperative complications in adult non-degenerative scoliosis.…”

Section: Discussionmentioning

confidence: 99%

Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis

Shao

Zhang

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

Introduction Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied. Methods We evaluated clinical and radiographical results from 146 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis. Results One hundred forty-six adult non-degenerative scoliosis patients were included in our study. There were 23 perioperative complications for 21 (14.4%) patients, eight of which were cardiopulmonary complications, two of which were infection, six of which were neurological complications, three of which were gastrointestinal complications, and four of which were incision-related complication. The independent risk factors for development of total perioperative complications included change in Cobb angle (odds ratio [OR] = 1.085, 95% CI = 1.035 ~ 1.137, P = 0.001) and spinal osteotomy (OR = 3.565, 95% CI = 1.039 ~ 12.236, P = 0.043). The independent risk factor for minor perioperative complications is change in Cobb angle (OR = 1.092, 95% CI = 1.023 ~ 1.165, P = 0.008). The independent risk factors for major perioperative complications are spinal osteotomy (OR = 4.475, 95% CI = 1.960 ~ 20.861, P = 0.036) and change in Cobb angle (OR = 1.106, 95% CI = 1.035 ~ 1.182, P = 0.003). Conclusions Our study indicate that change in Cobb angle and spinal osteotomy are independent risk factors for total perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients. Change in Cobb angle is an independent risk factor for minor perioperative complications. Change in Cobb angle and spinal osteotomy are independent risk factors for major perioperative complications.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis

Shao

Zhang

et al. 2021

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…This had been well reported in lumbar spinal fusion surgery with an increased rate of pseudoarthrosis, occurring up to four times in smokers compared with nonsmokers after lumbar spinal fusion. [3][4][5][6] Hilibrand and colleagues demonstrated poorer clinical outcomes among smokers when compared with nonsmokers in anterior cervical decompression and fusion. They postulated that the poorer outcomes were because of fusion-related complications as they found a strong association between the development of pseudoarthrosis and poor clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Does Cigarette Smoking Affect Cervical Laminoplasty Clinical and Radiologic Outcomes?

Liu¹,

Tan²,

Tan

et al. 2021

Clinical Spine Surgery: A Spine Publication

View full text Add to dashboard Cite

Study design: Retrospective review. Objective: This study aimed to investigate if smokers have both poorer early clinical and radiologic outcomes in cervical laminoplasty when compared with nonsmokers. Summary of Background Data: Cigarette smoking had been reported to increase rates of pseudoarthrosis following spinal instrumentation with fusion. Methodology: A retrospective review of all patients who underwent open-door cervical laminoplasty was performed. Nurick, neck pain visual analog scale, and neck disability index scores were reviewed. Cervical lordosis, range of motion (ROM), and intervertebral disc height were measured. The rates and reasons for revision surgery were recorded and classified according to the etiology of laminoplasty revision surgery. Results: Sixty patients were recruited, of which 20 patients (18 males, 2 females) were smokers and 40 patients (27 males, 13 females) were nonsmokers. There was no statistically significant difference between smokers and nonsmokers in preoperative and postoperative visual analog scale, neck disability index, and Nurick scores. A trend was noted toward a greater postoperative reduction in cervical lordosis (13±8 vs. 11±11 degrees). Furthermore, 41% of smokers versus 30% in nonsmokers had >10% loss of postoperative ROM, and 59% smokers versus 50% nonsmokers had >5% loss of postoperative ROM. Postoperative complications and intervertebral disc deterioration were similar in both groups. A higher reoperation rate was noted in smokers with 6 smokers (30%) as compared with 4 nonsmokers (10%), although this did not reach statistical significance. Among the smokers, 4 (20%) were because of cervical disease progression while 2 were technique related. In nonsmokers, all 4 (10%) were because of cervical disease progression. Conclusion: This study showed that while there was a nonstatistically significant trend noted toward higher rates of revision surgery in smokers, the laminoplasty outcomes were not significantly poorer in smokers. In heavy smokers with multilevel cervical myelopathy, laminoplasty may be the treatment of choice over anterior spinal decompression and fusion where a high risk of pseudoarthrosis is anticipated.

show abstract

“…The operation of DS is often accompanied by a high risk of complications due to older age, osteoporosis, and other organ diseases [ 28 ]. The prevalence of revision is an important index to test the complications.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Short-Segment Fixation versus Long-Segment Fixation for Degenerative Scoliosis with Cobb Angle 20°~40°: A Retrospective Observational Study

Zhu

et al. 2020

Med Sci Monit

View full text Add to dashboard Cite

Background There remains a great deal of controversy regarding the selection of long-segment fixation and short-segment fixation, especially for degenerative scoliosis (DS) patients with Cobb angle 20°~40°. The purpose of this study was to investigate the effects of different fixation levels in DS patients with Cobb angle 20°~40°. Material/Methods We enrolled 96 DS patients, divided into a long-segment fixation group (>3 segments) and a short-segment fixation group (≤3 segments). The visual analogue scale (VAS) and Oswestry disability index (ODI) were used to evaluate the clinical outcomes. The spinal-pelvic parameters and complications were also collected and analyzed. Results The short-segment fixation group had the advantages of less blood loss, shorter operation time and shorter fluoroscopy time (P<0.05). The 2 groups achieved similar effects in leg pain (VAS) and ODI after operation (P>0.05); however, there was a better relief of low back pain in the long-segment fixation group (P<0.05 ) . The changes of Cobb angle, sagittal vertical axis (SVA), lumbar lordosis (LL), pelvic tilt (PT) and sacral slope (SS) in the long-segment fixation group were more obvious than that in the short-segment fixation group at the final follow-up (P<0.05). The prevalence of complications in the long-segment fixation group was significantly higher than in the short-segment fixation group (P<0.01). Conclusions Short-segment fixation has less surgical trauma and fewer complications, whereas long-segment fixation has more advantages in improving spine-pelvis parameters and relieving low back pain.

show abstract

Risk factors for medical complications after long-level internal fixation in the treatment of adult degenerative scoliosis

Abstract: Heart disease comorbidity is an independent risk factor for both medical and major medical complications. Smoking, fusion level, and LOS are independent risk factors for medical complication. Diabetes is the independent risk factors for major medical complications.

Cited by 13 publications

References 45 publications

Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis

Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis

Does Cigarette Smoking Affect Cervical Laminoplasty Clinical and Radiologic Outcomes?

Effectiveness of Short-Segment Fixation versus Long-Segment Fixation for Degenerative Scoliosis with Cobb Angle 20°~40°: A Retrospective Observational Study

Contact Info

Product

Resources

About