A Comprehensive Review of Complication Rates after Surgery for Adult Deformity

A Reference for Informed Consent

Daniel Sciubba, Alp Yurter, Justin S. Smith, Michael P. Kelly, Justin K. Scheer, C. Rory Goodwin, Virginie Lafage, Robert A. Hart, Shay Bess, Khaled M Kebaish, Frank Schwab, Christopher I. Shaffrey, Christopher P. Ames

Research output: Contribution to journalArticle

Abstract

Objective An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. Methods A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). Results Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. Conclusions A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.

Original languageEnglish (US)
Pages (from-to)575-594
Number of pages20
JournalSpine Deformity
Volume3
Issue number6
DOIs
StatePublished - 2015

Fingerprint

Osteotomy
Informed Consent
PubMed
Case-Control Studies
Decision Making
Cohort Studies
Randomized Controlled Trials
Databases
Incidence

Keywords

  • Adult spinal deformity
  • Complications
  • PSO
  • Scoliosis
  • Three-column osteotomy

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

A Comprehensive Review of Complication Rates after Surgery for Adult Deformity : A Reference for Informed Consent. / Sciubba, Daniel; Yurter, Alp; Smith, Justin S.; Kelly, Michael P.; Scheer, Justin K.; Goodwin, C. Rory; Lafage, Virginie; Hart, Robert A.; Bess, Shay; Kebaish, Khaled M; Schwab, Frank; Shaffrey, Christopher I.; Ames, Christopher P.

In: Spine Deformity, Vol. 3, No. 6, 2015, p. 575-594.

Research output: Contribution to journalArticle

Sciubba, D, Yurter, A, Smith, JS, Kelly, MP, Scheer, JK, Goodwin, CR, Lafage, V, Hart, RA, Bess, S, Kebaish, KM, Schwab, F, Shaffrey, CI & Ames, CP 2015, 'A Comprehensive Review of Complication Rates after Surgery for Adult Deformity: A Reference for Informed Consent', Spine Deformity, vol. 3, no. 6, pp. 575-594. https://doi.org/10.1016/j.jspd.2015.04.005
Sciubba, Daniel ; Yurter, Alp ; Smith, Justin S. ; Kelly, Michael P. ; Scheer, Justin K. ; Goodwin, C. Rory ; Lafage, Virginie ; Hart, Robert A. ; Bess, Shay ; Kebaish, Khaled M ; Schwab, Frank ; Shaffrey, Christopher I. ; Ames, Christopher P. / A Comprehensive Review of Complication Rates after Surgery for Adult Deformity : A Reference for Informed Consent. In: Spine Deformity. 2015 ; Vol. 3, No. 6. pp. 575-594.
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abstract = "Objective An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. Methods A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). Results Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55{\%}. Specifically, major perioperative complications occurred at a mean rate of 18.5{\%}, minor perioperative complications occurred at a mean rate of 15.7{\%}, and long-term complications occurred at a mean rate of 20.5{\%}. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. Conclusions A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.",
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T1 - A Comprehensive Review of Complication Rates after Surgery for Adult Deformity

T2 - A Reference for Informed Consent

AU - Sciubba, Daniel

AU - Yurter, Alp

AU - Smith, Justin S.

AU - Kelly, Michael P.

AU - Scheer, Justin K.

AU - Goodwin, C. Rory

AU - Lafage, Virginie

AU - Hart, Robert A.

AU - Bess, Shay

AU - Kebaish, Khaled M

AU - Schwab, Frank

AU - Shaffrey, Christopher I.

AU - Ames, Christopher P.

PY - 2015

Y1 - 2015

N2 - Objective An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. Methods A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). Results Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. Conclusions A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.

AB - Objective An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. Methods A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). Results Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. Conclusions A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.

KW - Adult spinal deformity

KW - Complications

KW - PSO

KW - Scoliosis

KW - Three-column osteotomy

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