Database study highlights perioperative complication risks from cervical spine surgery

LAS VEGAS — Information collected from the Prospective Spine Treatment Outcome Study database, which documents perioperative adverse events for 1,269 patients who underwent cervical spine surgery throughout North America, indicates that older patients and patients who had multiple-level posterior procedures had higher complication rates.

“As expected, perioperative complication rates in cervical spine surgery are significantly lower in younger patients, surgery performed through an anterior approach, with fewer levels involved, and in primary procedures, while complication rates are higher in older patients, surgery performed through a posterior or front/back approach, with more levels involved and in revision procedures,” Steven Leckie, MD, said at the American Academy of Orthopaedic Surgeons Annual Meeting, here.

Using the database, Leckie and his colleagues designated 3 months as the perioperative period. Follow-up at this time period was 41%.

“The lowest rate of complications for primary procedures were performed through an anterior approach. Revision procedures were intermediate risk and multilevel posterior procedures and revision front and back procedures had the highest rates of complications,” he said.

Adverse events occurred at rates of 18.5%, 16% and 6.5%, for posterior, combined and anterior procedures, respectively. The investigators found the complication rate for revision surgery was 14.5% vs. 7.5% for primary surgery.

“For patients who had anterior surgery, those who had one, two, and three or more levels operated had no significant difference in complication rates,” Leckie said, adding that patients who had posterior surgery had significantly more complications if they were operated on multiple levels.

“The lowest rates of complications were for one-level primary surgery, while multiple-level posterior, revision posterior and revision combined surgery had complication rates of over six-times higher,” Leckie said. – by Gina Brockenbrough, MA

Reference:

Leckie S, et al. Paper #52. Presented at the: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.

Disclosure: Leckie reports no relevant financial disclosures.