Study shows 70% rate of complications within 2 years of surgery for adult spinal deformity

ORLANDO, Fla. — An investigation by Eric O. Klineberg, MD, and colleagues characterized the intraoperative and perioperative surgical complications for adult spinal deformity and showed these complications were mostly implant-related, radiographic, neurologic, operative, infectious and cardiopulmonary in nature.

“Although surgical treatment for [adult spinal deformity] ASD can improve pain and disability, it is associated with high rates of complications. Most of those complications occurred in those six specific categories: implant, radiographic, neurologic, operative, cardiopulmonary and infections. Our clear mandate is to understand how those complications affect the ultimate outcome,” Klineberg said in a presentation at the American Academy of Orthopaedic Surgeons Annual Meeting.

Eric O. Klineberg

Investigators studied 290 patients in the International Spine Study Group prospective multicenter ASD database. Intraoperative and perioperative complications, those that occurred prior to 6 postoperative weeks, were collected. Patients had an average age of 56 years and, overall, 25% underwent anterior procedures.

Two-year outcomes were available for 246 patients, and 203 of those patients had a complication.

“That is, 70% of patients either had a major or a minor complication; so a significant problem for our patients, and certainly when we think about costs,” Klineberg said.

Investigators also analyzed specific types of complications and whether they occurred early or delayed.

“When we look at the specific complications that occurred, we see rod breakage and implant prominence occurred most often in the delayed fashion. Radiographic problems, including [proximal junction kyphosis] PJK and pseudarthrosis, also occurred in a delayed fashion,” he said.

The most common complications occurred in the time periods that might be expected — both the perioperative and delayed time points, Klineberg noted.

“We did notice that the complication rate did occur with age and there was an increased propensity for complications that occurred as our patients got older, particularly for major complications,” Klineberg said.

As a caveat to these findings, he noted the database used for the study is evolving, which makes it difficult to draw hard and fast conclusions. – by Susan M. Rapp

Reference:

Klineberg EO, et al. Paper #212. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 1-5, 2016; Orlando, Fla.

Disclosure: Klineberg reports he is a paid presenter or speaker for and receives research support from AO Spine, receives researcher support from DePuy Synthes Spine, is a paid consultant for DePuy, a Johnson & Johnson Company, is a paid presenter or speaker for K2M, receives research support from OREF and is a pain consultant for Stryker.