Non-Neurological Complications Following Surgery for Adolescent Idiopathic Scoliosis

Purpose: To determine the incidence of non-neurologic complications following surgery for adolescent idiopathic scoliosis.

Methods: In a prospective cohort of 702 patients who underwent corrective surgery for adolescent idiopathic scoliosis enrolled in a multi-center database, demographics, surgical history and incidence of non-neurologic complications were reviewed. Non-neurological complications were divided into peri-operative (first 7 days post-op), early (within 30 days), and late (after 30 days).

Results: There were 556 females and 147 males with a mean age at the time of surgery of 14.25 years (7-18). 523 had posterior only, 105 anterior only, and 74 combined anterior/posterior procedure. There were 116 complications in 84 patients giving an overall incidence of 16%. There were 43 peri-operative complications in 41 patients, 52 early complications in 47, and 21 late complications in 17. There were 4 (0.5%) early infections, 25 (3.6%) operative, 13 (1.7%) respiratory, 3 (0.4%) superior mesenteric syndrome, 3 (0.4%) urinary, and 68 (6.6%) other complications. Five patients (0.7%) required re-operations: Two early infections and three late implant failures. Body mass index, cardiac or respiratory disease, previous surgery, pulmonary function, surgical approach, numbers of levels fused, type of graft, diaphragmatic incision, Lenke type, and region of major curve did not correlate with an increased incidence of complications. Renal disease and smaller proximal thoracic curves were associated with non-neurologic complications. Increased blood loss, prolonged posterior operative time and anesthesia time were associated with higher incidences of non-neurologic complications in the peri-operative period. Prolonged anesthesia time was also associated with a higher incidence of late non-neurologic complications.

Conclusions: The incidence of non-neurologic postoperative complications following corrective surgery for adolescent idiopathic scoliosis appears to be low at 16%. The few factors noted to significantly increase the rate of complications include history of renal disease, increased operative blood loss, prolonged posterior surgery time and anesthesia time.