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Risk Factors and Complications After Posterior Fusion for Scoliosis
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Posted on: 10/11/2007
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Degenerative scoliosis (curvature of the spine) in older adults affects the lumbar spine. Surgery to fuse the spine may be needed. Complications are a major problem in this age group after surgery for adult degenerative scoliosis.
In this study, researchers from Korea report on early and late complications of this treatment. Early problems were defined as anything occurring within the first three months after surgery. Patients were followed for at least two years for later complications.
Early complications can include blood clots, infection, and a paralyzed bowel. Some patients also experience nerve damage or problems breathing shortly after surgery.
Later, screw loosening and failure of the fusion may be reported. Other late complications include pseudoarthrosis (movement at the fusion site) and degeneration at the next vertebral level.
In this group of 47 patients, the overall complication rate was 68 per cent. Older patients (65 years old and older) were more likely to have early complications. Men and women were affected equally. Patients with other problems such as heart disease, diabetes, or high blood pressure were more likely to have problems early on.
Blood loss during the operation was the biggest risk factor for early complications. Fusion at more than five levels also increased the risk of early problems. These two risk factors are linked as blood loss increases with an increased number of levels fused.
The only risk factor the authors could identify for late complications was severity of the scoliosis. Poor improvement was seen most often in patients with the greatest imbalance of the normal spinal curvature. Having early complications did not increase the risk of problems developing later.
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References:
Kyu-Jung Cho, MD, et al. Complications in Posterior Fusion and Instrumentation for Degenerative Lumbar Scoliosis. In Spine. September 15, 2007. Vol. 32. No. 20. Pp. 2232-2237.
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