Complications in Spinal Fusion for Scheuermann’s Kyphosis. A Report of the Scoliosis Research Society Morbidity and Mortality Committee

Introduction: The surgical management of Scheuermann's kyphosis (SK) demonstrates significant variability between spinal deformity surgeons regarding age of the patient at the time of surgery and surgical approach. The influence of age and surgical approach on complications of the surgical treatment of SK, however, has not been well-defined. The purpose of this study is to determine whether patient age or surgical approach are independent predictors of complications in surgery for Scheuermann's kyphosis through analysis of the SRS M & M database of self-reported complications as submitted by its members.

Materials and Methods: This retrospective study used SRS Morbidity and Mortality data submitted for surgical cases performed from 2001-2004. The null hypotheses are: 1) that age at time of surgery, adolescent (age 13-19 vs. Adult (age > 19)), has no effect on the overall rates of recorded complications and 2 ) that surgical approach used for instrumentation and fusion of AIS (anterior-only, posterior, and combined) has no effect on the overall rates, types or frequencies of recorded complications. Of the 78,561 surgical cases submitted by SRS members in the years 2001 through 2004; 2,773 (3.5%) were performed for the treatment of kyphosis. The 670 patients (24.2% of kyphosis cases) identified as having spinal fusion for SK comprised the cohort under study. All reported complications were tabulated and totaled for these procedures with regards to age group and approach; and statistical analysis conducted.

Results: Complications were reported in 84 (12.5%) of the 670 patients in this series. Fifty (10.3%) of the 484 adolescents in this series and in 34 (18.3%) of the 186 adults in this series experienced complications. This difference was statistically significant (p <0 .05). Forty-two (12.7%) of the 332 patients who underwent posterior fusion experienced complications and 39 (14.6%) 267 same day anterior-posterior complications. There was no statistical difference in overall complication rates between same-day procedures (p="" 0.312). Overall, most common were wound infections (3.7%). The neurologic rate 1.9% with four documented spinal cord injuries (0.6%). Four (0.6%) died from their surgery.