TY - JOUR
T1 - Prospective Multicenter Assessment of Early Complication Rates Associated with Adult Cervical Deformity Surgery in 78 Patients
AU - On behalf of The International Spine Study Group
AU - Smith, Justin S.
AU - Ramchandran, Subaraman
AU - Lafage, Virginie
AU - Shaffrey, Christopher I.
AU - Ailon, Tamir
AU - Klineberg, Eric
AU - Protopsaltis, Themistocles
AU - Schwab, Frank J.
AU - O'Brien, Michael
AU - Hostin, Richard
AU - Gupta, Munish
AU - Mundis, Gregory
AU - Hart, Robert
AU - Kim, Han Jo
AU - Passias, Peter G.
AU - Scheer, Justin K.
AU - Deviren, Vedat
AU - Burton, Douglas C.
AU - Eastlack, Robert
AU - Bess, Shay
AU - Albert, Todd J.
AU - Daniel Riew, K.
AU - Ames, Christopher P.
N1 - Publisher Copyright:
© 2016 by the Congress of Neurological Surgeons.
PY - 2016/9/1
Y1 - 2016/9/1
N2 - Background: Few reports have focused on treatment of adult cervical deformity (ACD). OBJECTIVE: To present early complication rates associated with ACD surgery. METHODS: A prospective multicenter database of consecutive operative ACD patients was reviewed for early (≤30 days from surgery) complications. Enrollment required at least 1 of the following: cervical kyphosis >10 degrees, cervical scoliosis >10 degrees, C2-7 sagittal vertical axis >4 cm, or chin-brow vertical angle >25 degrees. RESULTS: Seventy-eight patients underwent surgical treatment for ACD (mean age, 60.8 years). Surgical approaches included anterior-only (14%), posterior-only (49%), anterior-posterior (35%), and posterior-anterior-posterior (3%). Mean numbers of fused anterior and posterior vertebral levels were 4.7 and 9.4, respectively. A total of 52 early complications were reported, including 26 minor and 26 major. Twenty-two (28.2%) patients had at least 1 minor complication, and 19 (24.4%) had at least 1 major complication. Overall, 34 (43.6%) patients had at least 1 complication. The most common complications included dysphagia (11.5%), deep wound infection (6.4%), new C5 motor deficit (6.4%), and respiratory failure (5.1%). One (1.3%) mortality occurred. Early complication rates differed significantly by surgical approach: anterior-only (27.3%), posterior-only (68.4%), and anterior-posterior/posterior-anterior-posterior (79.3%) (P.007). CONCLUSION: This report provides benchmark rates for overall and specific ACD surgery complications. Although the surgical approach(es) used were likely driven by the type and complexity of deformity, there were significantly higher complication rates associated with combined and posterior-only approaches compared with anterior-only approaches. These findings may prove useful in treatment planning, patient counseling, and ongoing efforts to improve safety of care.
AB - Background: Few reports have focused on treatment of adult cervical deformity (ACD). OBJECTIVE: To present early complication rates associated with ACD surgery. METHODS: A prospective multicenter database of consecutive operative ACD patients was reviewed for early (≤30 days from surgery) complications. Enrollment required at least 1 of the following: cervical kyphosis >10 degrees, cervical scoliosis >10 degrees, C2-7 sagittal vertical axis >4 cm, or chin-brow vertical angle >25 degrees. RESULTS: Seventy-eight patients underwent surgical treatment for ACD (mean age, 60.8 years). Surgical approaches included anterior-only (14%), posterior-only (49%), anterior-posterior (35%), and posterior-anterior-posterior (3%). Mean numbers of fused anterior and posterior vertebral levels were 4.7 and 9.4, respectively. A total of 52 early complications were reported, including 26 minor and 26 major. Twenty-two (28.2%) patients had at least 1 minor complication, and 19 (24.4%) had at least 1 major complication. Overall, 34 (43.6%) patients had at least 1 complication. The most common complications included dysphagia (11.5%), deep wound infection (6.4%), new C5 motor deficit (6.4%), and respiratory failure (5.1%). One (1.3%) mortality occurred. Early complication rates differed significantly by surgical approach: anterior-only (27.3%), posterior-only (68.4%), and anterior-posterior/posterior-anterior-posterior (79.3%) (P.007). CONCLUSION: This report provides benchmark rates for overall and specific ACD surgery complications. Although the surgical approach(es) used were likely driven by the type and complexity of deformity, there were significantly higher complication rates associated with combined and posterior-only approaches compared with anterior-only approaches. These findings may prove useful in treatment planning, patient counseling, and ongoing efforts to improve safety of care.
KW - Adult
KW - Cervical deformity
KW - Early complications
KW - Fusion
KW - Kyphosis
KW - Osteotomy
KW - Spine
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84947976349&partnerID=8YFLogxK
U2 - 10.1227/NEU.0000000000001129
DO - 10.1227/NEU.0000000000001129
M3 - Article
C2 - 26595429
AN - SCOPUS:84947976349
SN - 0148-396X
VL - 79
SP - 378
EP - 388
JO - Neurosurgery
JF - Neurosurgery
IS - 3
ER -