Perioperative Complications of Spinal Fusion for Thoracic Adolescent Idiopathic Scoliosis

· (a – DePuy AcroMed)

Most papers on complications following spine surgery are clouded by the grouping of multiple diagnoses, with few concentrating solely on idiopathic scoliosis. The purpose of this paper is to analyze the perioperative complications of patients with thoracic adolescent idiopathic scoliosis (AIS) treated with either anterior spinal fusion (ASF) or posterior spinal fusion (PSF).

Methods: A prospective database of 673 patients with thoracic AIS was analyzed. ‘Perioperative’ complications (within 3 months of surgery) were defined as ‘major’ (those that caused permanent sequelae, necessitated a second major operation, or required a prolonged hospital stay [> 3 weeks]) or ‘minor’ (those that necessitated a minor operation, caused significant temporary hardship, caused persistent minor problems, or prolonged the hospital stay [< 3 weeks]). Of the 673 patients, 358 had ASF and 315 had PSF. The average preoperative curve was 51° in the ASF group and 54° in the PSF group. Average age at surgery was 14 years.

Results: There were 3 major complications (0.4%), including two cases of acute respiratory distress syndrome (1 ASF, 1 PSF) and 1 case of reoperation for screw pullout (ASF), but none resulted in permanent sequelae. There were 32 minor complications in the 673 patients (4.8%). 19/358 patients (5.3%) in the ASF group had minor complications compared to 13/315 (4.1%) in the PSF group.

Conclusions: Perioperative complications of surgery for thoracic AIS were rare, with 3 major complications (0.4%), without any permanent sequelae, and 32 minor complications (4.8%). There was no significant difference between the ASF and PSF groups.

· If noted, the author indicates something of value received. The codes are identified as: a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options.