Susana Núñez-Pereira, Ferran Pellisé, Alba Vila-Casademunt, Ahmet Alanay, Emre Acaraglou, Ibrahim Obeid, Francisco Javier Sánchez Pérez-Grueso, Frank Kleinstück


September 2019, Volume 28, Issue 9, pp 2208 - 2215 Original Article Read Full Article 10.1007/s00586-019-06041-x

First Online: 27 June 2019

Impact of resolved early major complications on 2-year follow-up outcome following adult spinal deformity surgery

Purpose

Major complications are a concern following ASD surgery. Even when properly managed and resolved, they may still have a relevant impact on HRQL. We aimed to investigate the impact of resolved early major complications on 2-year outcome after ASD surgery.

Methods

Two groups of consecutive surgical patients were extracted from a prospective multicentre database. Major complication group (MCG) included patients with any major complication, resolved within 6 months after surgery. Patients with further major complications during follow-up were excluded. Control group (CG) included patients with no major complications over the entire follow-up. Analysis of covariance adjusting for preoperative baseline values was used to compare improvements in HRQL measures at 2 years.

Results

One hundred and seventy-five patients met the inclusion criteria and had complete HRQL data at 2 years (24 MCG, 151 CG). MCG patients were older and had more severe deformity and poorer baseline HRQL. There were 27 resolved major complications at 6 months needing 19 additional surgeries (18 revisions, 1 cholecystectomy). At 2 years, and after adjusting for preoperative data, outcome in MCG patients was as follows: scores were 5.98 (SE 3.03) points higher for the ODI (p = 0.05), 0.36 (SE 0.13) lower SRS-22 function (p = 0.01), 4.07 (SE 1.93) lower SF-36 PCS (p = 0.04), and 0.16 (SE 0.13) lower SRS-22 subtotal (p = 0.22).

Conclusion

The results indicate that patients experiencing major complications after ASD surgery have significantly less functional improvement (SRS-22 function, ODI, SF-36 PCS) than their complication-free counterparts, even when complications were considered resolved, and the outcome was measured after an 18-month complication-free period.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]


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