Non-neurologic complications following surgery for adolescent idiopathic scoliosis

Leah Y. Carreon, Rolando M. Puno, Lawrence G. Lenke, B. Stephen Richards, Daniel J. Sucato, John B. Emans, Mark A. Erickson

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Abstract

Background: The reported prevalence of non-neurologic complications following corrective surgery for adolescent idiopathic scoliosis ranges from 0% to 10%. However, most studies were retrospective evaluations of treatment techniques and did not focus solely on complications. The purpose of this study was to determine the prevalence of non-neurologic complications following surgery for adolescent idiopathic scoliosis and to identify preoperative and operative factors that can increase this risk. Methods: The demographic data, medical and surgical histories, and prevalence of non-neurologic complications were reviewed in a prospective cohort of 702 patients who had undergone corrective surgery for adolescent idiopathic scoliosis and were consecutively enrolled in a multicenter database. Results: There were 556 female and 146 male patients. The mean age at the time of surgery was 14.25 years (range, eight to eighteen years). Five hundred and twenty-three patients had only posterior spinal surgery, 105 had only anterior spinal surgery, and seventy-four had a combined anterior and posterior procedure. There was a total of 108 complications in eighty-one patients, for an overall prevalence of 15.4%. There were ten respiratory complications (1.42%), six cases of excessive bleeding (0.85%), five wound infections (0.71%), and five cases of wound hematoma, seroma, or dehiscence (0.71%). Five patients, two with an early infection and three with late failure of the implant, required a reoperation. Factors that did not correlate with an increased prevalence of complications were age, body mass index, presence of cardiac or respiratory disease, previous surgery, pulmonary function, surgical approach, number of levels fused, graft material, use of a diaphragmatic incision, Lenke curve type, or region of the major curve. Although the number of patients with renal disease was small, these patients were 7.90 times more likely to have a non-neurologic complication. Increased blood loss as well as prolonged operative and anesthesia times were associated with a higher prevalence of non-neurologic complications. Conclusions: The prevalence of non-neurologic postoperative complications following surgery for correction of adolescent idiopathic scoliosis in this study was 15.4%. The few factors noted to significantly increase the rate of complications include a history of renal disease, increased operative blood loss, prolonged posterior surgery time, and prolonged anesthesia time. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)2427-2432
Number of pages6
JournalJournal of Bone and Joint Surgery - Series A
Volume89
Issue number11
DOIs
StatePublished - Nov 2007

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Scoliosis
Anesthesia
Kidney
Seroma
Wound Infection
Operative Time
Reoperation
Hematoma
Body Mass Index
Retrospective Studies
Demography
Databases
Hemorrhage
Transplants
Lung
Wounds and Injuries
Infection

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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Non-neurologic complications following surgery for adolescent idiopathic scoliosis. / Carreon, Leah Y.; Puno, Rolando M.; Lenke, Lawrence G.; Richards, B. Stephen; Sucato, Daniel J.; Emans, John B.; Erickson, Mark A.

In: Journal of Bone and Joint Surgery - Series A, Vol. 89, No. 11, 11.2007, p. 2427-2432.

Research output: Contribution to journalArticle

Carreon, Leah Y. ; Puno, Rolando M. ; Lenke, Lawrence G. ; Richards, B. Stephen ; Sucato, Daniel J. ; Emans, John B. ; Erickson, Mark A. / Non-neurologic complications following surgery for adolescent idiopathic scoliosis. In: Journal of Bone and Joint Surgery - Series A. 2007 ; Vol. 89, No. 11. pp. 2427-2432.
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abstract = "Background: The reported prevalence of non-neurologic complications following corrective surgery for adolescent idiopathic scoliosis ranges from 0{\%} to 10{\%}. However, most studies were retrospective evaluations of treatment techniques and did not focus solely on complications. The purpose of this study was to determine the prevalence of non-neurologic complications following surgery for adolescent idiopathic scoliosis and to identify preoperative and operative factors that can increase this risk. Methods: The demographic data, medical and surgical histories, and prevalence of non-neurologic complications were reviewed in a prospective cohort of 702 patients who had undergone corrective surgery for adolescent idiopathic scoliosis and were consecutively enrolled in a multicenter database. Results: There were 556 female and 146 male patients. The mean age at the time of surgery was 14.25 years (range, eight to eighteen years). Five hundred and twenty-three patients had only posterior spinal surgery, 105 had only anterior spinal surgery, and seventy-four had a combined anterior and posterior procedure. There was a total of 108 complications in eighty-one patients, for an overall prevalence of 15.4{\%}. There were ten respiratory complications (1.42{\%}), six cases of excessive bleeding (0.85{\%}), five wound infections (0.71{\%}), and five cases of wound hematoma, seroma, or dehiscence (0.71{\%}). Five patients, two with an early infection and three with late failure of the implant, required a reoperation. Factors that did not correlate with an increased prevalence of complications were age, body mass index, presence of cardiac or respiratory disease, previous surgery, pulmonary function, surgical approach, number of levels fused, graft material, use of a diaphragmatic incision, Lenke curve type, or region of the major curve. Although the number of patients with renal disease was small, these patients were 7.90 times more likely to have a non-neurologic complication. Increased blood loss as well as prolonged operative and anesthesia times were associated with a higher prevalence of non-neurologic complications. Conclusions: The prevalence of non-neurologic postoperative complications following surgery for correction of adolescent idiopathic scoliosis in this study was 15.4{\%}. The few factors noted to significantly increase the rate of complications include a history of renal disease, increased operative blood loss, prolonged posterior surgery time, and prolonged anesthesia time. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.",
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T1 - Non-neurologic complications following surgery for adolescent idiopathic scoliosis

AU - Carreon, Leah Y.

AU - Puno, Rolando M.

AU - Lenke, Lawrence G.

AU - Richards, B. Stephen

AU - Sucato, Daniel J.

AU - Emans, John B.

AU - Erickson, Mark A.

PY - 2007/11

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N2 - Background: The reported prevalence of non-neurologic complications following corrective surgery for adolescent idiopathic scoliosis ranges from 0% to 10%. However, most studies were retrospective evaluations of treatment techniques and did not focus solely on complications. The purpose of this study was to determine the prevalence of non-neurologic complications following surgery for adolescent idiopathic scoliosis and to identify preoperative and operative factors that can increase this risk. Methods: The demographic data, medical and surgical histories, and prevalence of non-neurologic complications were reviewed in a prospective cohort of 702 patients who had undergone corrective surgery for adolescent idiopathic scoliosis and were consecutively enrolled in a multicenter database. Results: There were 556 female and 146 male patients. The mean age at the time of surgery was 14.25 years (range, eight to eighteen years). Five hundred and twenty-three patients had only posterior spinal surgery, 105 had only anterior spinal surgery, and seventy-four had a combined anterior and posterior procedure. There was a total of 108 complications in eighty-one patients, for an overall prevalence of 15.4%. There were ten respiratory complications (1.42%), six cases of excessive bleeding (0.85%), five wound infections (0.71%), and five cases of wound hematoma, seroma, or dehiscence (0.71%). Five patients, two with an early infection and three with late failure of the implant, required a reoperation. Factors that did not correlate with an increased prevalence of complications were age, body mass index, presence of cardiac or respiratory disease, previous surgery, pulmonary function, surgical approach, number of levels fused, graft material, use of a diaphragmatic incision, Lenke curve type, or region of the major curve. Although the number of patients with renal disease was small, these patients were 7.90 times more likely to have a non-neurologic complication. Increased blood loss as well as prolonged operative and anesthesia times were associated with a higher prevalence of non-neurologic complications. Conclusions: The prevalence of non-neurologic postoperative complications following surgery for correction of adolescent idiopathic scoliosis in this study was 15.4%. The few factors noted to significantly increase the rate of complications include a history of renal disease, increased operative blood loss, prolonged posterior surgery time, and prolonged anesthesia time. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.

AB - Background: The reported prevalence of non-neurologic complications following corrective surgery for adolescent idiopathic scoliosis ranges from 0% to 10%. However, most studies were retrospective evaluations of treatment techniques and did not focus solely on complications. The purpose of this study was to determine the prevalence of non-neurologic complications following surgery for adolescent idiopathic scoliosis and to identify preoperative and operative factors that can increase this risk. Methods: The demographic data, medical and surgical histories, and prevalence of non-neurologic complications were reviewed in a prospective cohort of 702 patients who had undergone corrective surgery for adolescent idiopathic scoliosis and were consecutively enrolled in a multicenter database. Results: There were 556 female and 146 male patients. The mean age at the time of surgery was 14.25 years (range, eight to eighteen years). Five hundred and twenty-three patients had only posterior spinal surgery, 105 had only anterior spinal surgery, and seventy-four had a combined anterior and posterior procedure. There was a total of 108 complications in eighty-one patients, for an overall prevalence of 15.4%. There were ten respiratory complications (1.42%), six cases of excessive bleeding (0.85%), five wound infections (0.71%), and five cases of wound hematoma, seroma, or dehiscence (0.71%). Five patients, two with an early infection and three with late failure of the implant, required a reoperation. Factors that did not correlate with an increased prevalence of complications were age, body mass index, presence of cardiac or respiratory disease, previous surgery, pulmonary function, surgical approach, number of levels fused, graft material, use of a diaphragmatic incision, Lenke curve type, or region of the major curve. Although the number of patients with renal disease was small, these patients were 7.90 times more likely to have a non-neurologic complication. Increased blood loss as well as prolonged operative and anesthesia times were associated with a higher prevalence of non-neurologic complications. Conclusions: The prevalence of non-neurologic postoperative complications following surgery for correction of adolescent idiopathic scoliosis in this study was 15.4%. The few factors noted to significantly increase the rate of complications include a history of renal disease, increased operative blood loss, prolonged posterior surgery time, and prolonged anesthesia time. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence.

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