Peak Timing for Complications After Adult Spinal Deformity Surgery

International Spine Study Group Foundation

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Overall complication rates for adult spinal deformity (ASD) surgery have been reported; however, little data exist on the peak timing associated with specific complications. This study quantifies the peak timing for multiple complication types in an ASD cohort at minimum 2-year follow-up. Methods: Multicenter, prospective analysis of all complications after ASD surgery in a consecutively enrolled cohort was performed. Inclusion criteria were ASD, age ≥18 years, spinal fusion ≥4 levels, and minimum 2-year follow-up. Complications included major and minor and specific complication types. Peak timing of specific complications was identified and described. Regression analysis was performed to assess correlation between patient/surgical factors and complication timing. Results: There were 280 patients who met the inclusion criteria. Mean follow-up time was 2.9 years (range, 2–5 years). Of the patients, 209 (74.6%) had at least 1 complication, accounting for 529 total complications (258 minor and 271 major). Both major and minor complications peaked at <3 months. Infection and neurologic complications peaked at <3 months. Proximal junctional kyphosis had bimodal peaks at <3 and >24 months. Implant failure peaked at 12–24 and >24 months. There was a significant positive correlation between preoperative sagittal vertical axis and total complications at 6–12 months, major complications at 24 months, and reoperation. Body mass index was associated with total complications and implant failure at 12–24 and >24 months. Conclusions: The peak timing of specific complications after ASD surgery is identifiable. Understanding when these complications are likely to occur may improve patient counseling, early diagnosis, and prophylactic interventions and may help inform future reimbursement models.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Spinal Fusion
Reoperation
Counseling
Early Diagnosis
Body Mass Index
Regression Analysis

Keywords

  • Adult spinal deformity
  • Complications
  • Fusion
  • Infection
  • Outcomes
  • PJK

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Peak Timing for Complications After Adult Spinal Deformity Surgery. / International Spine Study Group Foundation.

In: World Neurosurgery, 01.01.2018.

Research output: Contribution to journalArticle

International Spine Study Group Foundation. / Peak Timing for Complications After Adult Spinal Deformity Surgery. In: World Neurosurgery. 2018.
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title = "Peak Timing for Complications After Adult Spinal Deformity Surgery",
abstract = "Background: Overall complication rates for adult spinal deformity (ASD) surgery have been reported; however, little data exist on the peak timing associated with specific complications. This study quantifies the peak timing for multiple complication types in an ASD cohort at minimum 2-year follow-up. Methods: Multicenter, prospective analysis of all complications after ASD surgery in a consecutively enrolled cohort was performed. Inclusion criteria were ASD, age ≥18 years, spinal fusion ≥4 levels, and minimum 2-year follow-up. Complications included major and minor and specific complication types. Peak timing of specific complications was identified and described. Regression analysis was performed to assess correlation between patient/surgical factors and complication timing. Results: There were 280 patients who met the inclusion criteria. Mean follow-up time was 2.9 years (range, 2–5 years). Of the patients, 209 (74.6{\%}) had at least 1 complication, accounting for 529 total complications (258 minor and 271 major). Both major and minor complications peaked at <3 months. Infection and neurologic complications peaked at <3 months. Proximal junctional kyphosis had bimodal peaks at <3 and >24 months. Implant failure peaked at 12–24 and >24 months. There was a significant positive correlation between preoperative sagittal vertical axis and total complications at 6–12 months, major complications at 24 months, and reoperation. Body mass index was associated with total complications and implant failure at 12–24 and >24 months. Conclusions: The peak timing of specific complications after ASD surgery is identifiable. Understanding when these complications are likely to occur may improve patient counseling, early diagnosis, and prophylactic interventions and may help inform future reimbursement models.",
keywords = "Adult spinal deformity, Complications, Fusion, Infection, Outcomes, PJK",
author = "{International Spine Study Group Foundation} and Daniels, {Alan H.} and Shay Bess and Breton Line and Eltorai, {Adam E.M.} and Reid, {Daniel B.C.} and Virginie Lafage and Akbarnia, {Behrooz A.} and Ames, {Christopher P.} and Oheneba Boachie-Adjei and Burton, {Douglas C.} and Vedat Deviren and Kim, {Han Jo} and Hart, {Robert A.} and Kebaish, {Khaled M.} and Klineberg, {Eric Otto} and Munish Gupta and Mundis, {Gregory M.} and Hostin, {Richard A.} and Michael O'Brien and Schwab, {Frank J.} and Shaffrey, {Christopher I.} and Smith, {Justin S.}",
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T1 - Peak Timing for Complications After Adult Spinal Deformity Surgery

AU - International Spine Study Group Foundation

AU - Daniels, Alan H.

AU - Bess, Shay

AU - Line, Breton

AU - Eltorai, Adam E.M.

AU - Reid, Daniel B.C.

AU - Lafage, Virginie

AU - Akbarnia, Behrooz A.

AU - Ames, Christopher P.

AU - Boachie-Adjei, Oheneba

AU - Burton, Douglas C.

AU - Deviren, Vedat

AU - Kim, Han Jo

AU - Hart, Robert A.

AU - Kebaish, Khaled M.

AU - Klineberg, Eric Otto

AU - Gupta, Munish

AU - Mundis, Gregory M.

AU - Hostin, Richard A.

AU - O'Brien, Michael

AU - Schwab, Frank J.

AU - Shaffrey, Christopher I.

AU - Smith, Justin S.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Overall complication rates for adult spinal deformity (ASD) surgery have been reported; however, little data exist on the peak timing associated with specific complications. This study quantifies the peak timing for multiple complication types in an ASD cohort at minimum 2-year follow-up. Methods: Multicenter, prospective analysis of all complications after ASD surgery in a consecutively enrolled cohort was performed. Inclusion criteria were ASD, age ≥18 years, spinal fusion ≥4 levels, and minimum 2-year follow-up. Complications included major and minor and specific complication types. Peak timing of specific complications was identified and described. Regression analysis was performed to assess correlation between patient/surgical factors and complication timing. Results: There were 280 patients who met the inclusion criteria. Mean follow-up time was 2.9 years (range, 2–5 years). Of the patients, 209 (74.6%) had at least 1 complication, accounting for 529 total complications (258 minor and 271 major). Both major and minor complications peaked at <3 months. Infection and neurologic complications peaked at <3 months. Proximal junctional kyphosis had bimodal peaks at <3 and >24 months. Implant failure peaked at 12–24 and >24 months. There was a significant positive correlation between preoperative sagittal vertical axis and total complications at 6–12 months, major complications at 24 months, and reoperation. Body mass index was associated with total complications and implant failure at 12–24 and >24 months. Conclusions: The peak timing of specific complications after ASD surgery is identifiable. Understanding when these complications are likely to occur may improve patient counseling, early diagnosis, and prophylactic interventions and may help inform future reimbursement models.

AB - Background: Overall complication rates for adult spinal deformity (ASD) surgery have been reported; however, little data exist on the peak timing associated with specific complications. This study quantifies the peak timing for multiple complication types in an ASD cohort at minimum 2-year follow-up. Methods: Multicenter, prospective analysis of all complications after ASD surgery in a consecutively enrolled cohort was performed. Inclusion criteria were ASD, age ≥18 years, spinal fusion ≥4 levels, and minimum 2-year follow-up. Complications included major and minor and specific complication types. Peak timing of specific complications was identified and described. Regression analysis was performed to assess correlation between patient/surgical factors and complication timing. Results: There were 280 patients who met the inclusion criteria. Mean follow-up time was 2.9 years (range, 2–5 years). Of the patients, 209 (74.6%) had at least 1 complication, accounting for 529 total complications (258 minor and 271 major). Both major and minor complications peaked at <3 months. Infection and neurologic complications peaked at <3 months. Proximal junctional kyphosis had bimodal peaks at <3 and >24 months. Implant failure peaked at 12–24 and >24 months. There was a significant positive correlation between preoperative sagittal vertical axis and total complications at 6–12 months, major complications at 24 months, and reoperation. Body mass index was associated with total complications and implant failure at 12–24 and >24 months. Conclusions: The peak timing of specific complications after ASD surgery is identifiable. Understanding when these complications are likely to occur may improve patient counseling, early diagnosis, and prophylactic interventions and may help inform future reimbursement models.

KW - Adult spinal deformity

KW - Complications

KW - Fusion

KW - Infection

KW - Outcomes

KW - PJK

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