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Investigating Rate of Non-neurologic Complications Resulting from Surgery for Adolescent Idiopathic Scoliosis

Posted on: 11/15/2007
As surgery becomes more involved in correcting adolescent idiopathic scoliosis and with improved anesthetic techniques, perioperative (during surgery) monitoring, and after surgery care, researchers are interested in learning how often non-neurological complications occur following surgery for scoliosis correction and what the contributing factors may be.

The authors of this study undertook this study because previous studies had evaluated the treatment but did not focus specifically on the complications themselves.

A database of patients who had undergone surgery between December 2002 and December 2004 to correct adolescent idiopathic scoliosis was consulted. The final study group included 556 females and 146 males, aged between 8 to 18 years at the time of the surgery (mean: 14.25 years), who were followed for about 12.4 months. Among the group, 523 patients had the surgery from the posterior approach, 105 from the anterior approach, and 74 from both the posterior and anterior.

The researchers found that there was a 15.4 percent prevalence of complications in the study group overall. This included 43 complications during surgery in 41 patients, 44 early complications in 23 patients, and 21 late complications in 17 patients. Five patients required further surgery as a result of the complications: 2 because of infection and 3 because of implant failure. Although there were a number of complications that occurred only once, the most common non-neurological (affecting the nerves) complications were difficulties with respirations (10), excessive bleeding (6), wound infections (5), and wound hematoma (bruising and blood clotting), seroma (fluid under the wound), or dehiscence (wound opening) in 5 cases.

When the researchers analyzed the data, they found that more complications did occur in patients who had the posterior approach, but they appeared to be due to how long the surgery took, how long the patient was under anesthetic, and how much blood was lost during surgery. What did not appear to make any differences in the complication prevalence were patient age, body mass index, previous cardiac or respiratory disease, previous surgeries, pulmonary function, surgical approach, number of levels fused during surgery, materials used for grafting, curve type, or region of the curve. The researchers did note, however, that a history of renal disease did result in an increased prevalence.

References:
Leah Y. Carreon, MD, MSc. et al. Non-Neurologic Complications Following Surgery for Adolescent Idiopathic Scoliosis. In The Journal of Bone and Joint Surgery. November 2007. Vol. 89. No. 11. Pp. 2427-2432.

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