Acute complications in open/miss primary and revision thoracolumbar spine surgery: a descriptive study of the most common complications and treatment of choice.
Complications
Lumbar decompression
Spinal fusion
Spine surgery
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
29 Nov 2023
29 Nov 2023
Historique:
received:
03
07
2023
accepted:
15
11
2023
medline:
29
11
2023
pubmed:
29
11
2023
entrez:
29
11
2023
Statut:
aheadofprint
Résumé
Main question The aim of this study is to describe and analyze the frequency of acute perioperative (intraoperatively and 30 days after) complications of open/MISS thoracolumbar spine surgery. Secondary questions A) Describe the treatment of choice for every kind of complication mentioned. B) Perform a bibliographic search and compare the complications described and their frequency with those studied in the manuscript. A retrospective cohort of 816 patients undergoing spinal surgery over a two year period was analyzed. Acute complications of 59 patients are described whether those with a greater number of levels required longer periods of hospitalization. The frequency of acute complications was 7.2%. The most common was infection (2.7%), followed by dural tear (1.7%), and screw malpositioning (1%), which is consistent with the current literature. No statistically significant results were observed when comparing the mean length of hospital stay among patients operated on a greater number of levels compared to the rest (P: 0.344; 95% CI: -3.88-10.93). The subsidiary patient of spinal surgery is getting older and has more comorbidities, and therefore, has a higher risk of complications. Although there are models predicting the risk of complications, they are not used in routine clinical practice. It would be necessary to unify the main criteria and establish guidelines for risk detection and therapeutic algorithms based on new high-quality studies.
Identifiants
pubmed: 38019296
doi: 10.1007/s00264-023-06047-7
pii: 10.1007/s00264-023-06047-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2023. The Author(s) under exclusive licence to SICOT aisbl.
Références
Solumsmoen S, Bari TJ et al (2021) Morbidity and mortality following degenerative spine surgery in a prospective cohort of 1687 consecutive surgical procedures. Acta Neurochir 163:281–287. https://doi.org/10.1007/s00701-020-04655-5
doi: 10.1007/s00701-020-04655-5
pubmed: 33230624
Zehnder P, Held U, Pigott T et al (2021) Development of a model to predict the probability of incurring a complication during spine surgery. Eur Spine J 30:1337–1354. https://doi.org/10.1007/s00586-021-06777-5
doi: 10.1007/s00586-021-06777-5
pubmed: 33686535
Boss EF, Mehta N, Nagarajan N et al (2016) Shared decision making and choice for elective surgical care: a systematic review. Otolaryngol - Head Neck Surg (United States) 154:405–420
doi: 10.1177/0194599815620558
Nagata K, Shinozaki T, Yamada K et al (2020) A sliding scale to predict postoperative complications undergoing posterior spine surgery. J Orthop Sci 25:545–550. https://doi.org/10.1016/j.jos.2019.06.012
doi: 10.1016/j.jos.2019.06.012
pubmed: 31285117
Campbell PG, Malone J, Yadla S et al (2010) Early complications related to approach in thoracic and lumbar spine surgery: a single center prospective study. World Neurosurg 73:395–401
doi: 10.1016/j.wneu.2010.01.024
pubmed: 20849799
Abdul-Jabbar A, Berven SH, Hu SS et al (2013) Surgical site infections in spine surgery: Identification of microbiologic and surgical characteristics in 239 cases. Spine (Phila Pa 1976) 38(22):E1425–E1431. https://doi.org/10.1097/BRS.0b013e3182a42a68
doi: 10.1097/BRS.0b013e3182a42a68
pubmed: 23873240
Sexton DJ, Sampson JH (2022) Spinal epidural abscess [Internet]. https://www.uptodate.com
Nota SPFT, Braun Y, Ring D, Schwab JH (2015) Incidence of surgical site infection after spine surgery: what is the impact of the definition of infection? Clin Orthop Relat Res 473:1612–1619. https://doi.org/10.1007/s11999-014-3933-y
doi: 10.1007/s11999-014-3933-y
pubmed: 25212963
Hassanzadeh H, Bell J, Bhatia M, Puvanesarajah V (2021) Incidental durotomy in lumbar spine surgery; risk factors, complications, and perioperative management. J Am Acad Orthop Surg 29:e279–e286. https://doi.org/10.5435/JAAOS-D-20-00210
doi: 10.5435/JAAOS-D-20-00210
pubmed: 33539059
Guerin P, El Fegoun AB, Obeid I et al (2012) Incidental durotomy during spine surgery: Incidence, management and complications. A retrospective review. Injury 43:397–401
doi: 10.1016/j.injury.2010.12.014
pubmed: 21251652
Khan MH, Rihn J, Steele G et al (2006) Postoperative management protocol for incidental dural tears during degenerative lumbar spine surgery: a review of 3,183 consecutive degenerative lumbar cases. Spine 31(22):2609–2613. https://doi.org/10.1097/01.brs.0000241066.55849.41
Epstein NE (2007) The frequency and etiology of intraoperative Dural tears in 110 predominantly geriatric patients undergoing multilevel laminectomy with noninstrumented fusions. J Spinal Disord Tech 20:380–386
doi: 10.1097/BSD.0b013e31802dabd2
pubmed: 17607104
Bari TJ, Karstensen S, Sørensen MD et al (2020) Revision surgery and mortality following complex spine surgery: 2-year follow-up in a prospective cohort of 679 patients using the Spine AdVerse Event Severity (SAVES) system. Spine Deform 8:1341–1351. https://doi.org/10.1007/s43390-020-00164-8
doi: 10.1007/s43390-020-00164-8
pubmed: 32607936
Shuman WH, Valliani AA, Chapman EK et al (2022) Intraoperative navigation in spine surgery: effects on complications and reoperations. World Neurosurg 160:e404–e411. https://doi.org/10.1016/j.wneu.2022.01.035
doi: 10.1016/j.wneu.2022.01.035
pubmed: 35033690
Feng X et al (2021) Comparison of clinical outcomes and complications between percutaneous endoscopic and minimally invasive transforaminal lumbar interbody fusion for degenerative lumbar disease: a systematic review and meta-analysis. Pain Physician 24:441–452
doi: 10.36076/ppj.2021.24.441
pubmed: 34554684
Cha EDK, Lynch P, Hrynewycz NM et al (2021) Spine surgery complications in the ambulatory surgical center setting systematic review. Clin Spine Surg 35:118–126
doi: 10.1097/BSD.0000000000001225
Joaquim AF, Makhni MC, Riew KD (2019) Post-operative nerve injuries after cervical spine surgery. Int Orthop 43:791–795
doi: 10.1007/s00264-018-4257-4
pubmed: 30498911
Abola MV, Du JY, Lin CC et al (2021) Symptomatic epidural hematoma after elective cervical spine surgery: incidence, timing, risk factors, and associated complications. Oper Neurosurg 21:452–460. https://doi.org/10.1093/ons/opab344
doi: 10.1093/ons/opab344
Farshad M, Aichmair A, Gerber C, Bauer DE (2020) Classification of perioperative complications in spine surgery. Spine J 20:730–736. https://doi.org/10.1016/j.spinee.2019.12.013
doi: 10.1016/j.spinee.2019.12.013
pubmed: 31877388
Kirshblum SC, Waring W, Biering-Sorensen F et al (2011) Reference for the 2011 revision of the international standards for neurological classification of spinal cord injury. J Spinal Cord Med 34:547–554
doi: 10.1179/107902611X13186000420242
pubmed: 22330109
pmcid: 3232637
Kasparek MF, Boettner F, Rienmueller A et al (2018) Predicting medical complications in spine surgery: evaluation of a novel online risk calculator. Eur Spine J 27:2449–2456. https://doi.org/10.1007/s00586-018-5707-9
doi: 10.1007/s00586-018-5707-9
pubmed: 30056597
Lange N, Stadtmüller T, Scheibel S et al (2022) Analysis of risk factors for perioperative complications in spine surgery. Sci Rep 12. https://doi.org/10.1038/s41598-022-18417-z
Nagata K, Shinozaki T, Yamada K et al (2020) A sliding scale to predict postoperative complications undergoing posterior spine surgery. J Orthop Sci 25:545–550. https://doi.org/10.1016/j.jos.2019.06.012
doi: 10.1016/j.jos.2019.06.012
pubmed: 31285117
Cerpa M, Sardar Z, Lenke L (2020) Revision surgery in proximal junctional kyphosis. Eur Spine J 29:78–85. https://doi.org/10.1007/s00586-020-06320-y
doi: 10.1007/s00586-020-06320-y
pubmed: 32016539