European Spine Journal

, Volume 28, Issue 9, pp 2208–2215 | Cite as

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

  • Susana Núñez-PereiraEmail author
  • Ferran Pellisé
  • Alba Vila-Casademunt
  • Ahmet Alanay
  • Emre Acaraglou
  • Ibrahim Obeid
  • Francisco Javier Sánchez Pérez-Grueso
  • Frank Kleinstück
  • ESSG European Spine Study Group
Original Article



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.


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.


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).


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.


Adult spinal deformity Complications Outcome 



Depuy Synthes Spine research Grant funds were received in support of this study. The results of this study were presented at the XXXII GEER Meeting (Spanish Spine Society).

Complinace with ethical standards

Conflict of interest

SNP and AVC have no conflict of interest. AA, EA, FP, IO, FK and FJSPG have received grants from Depuy Synthes Spine), AA and FP have received grants from Medtronic. FP, IO and FJSPG are consultants for Depuy Synthes Spine, FP is consultant for K2M and IO is Consultant for Medtronic. IO receives royalties from Alpahtech, Clariance and Spineart).

Supplementary material

586_2019_6041_MOESM1_ESM.pptx (195 kb)
Supplementary file1 (PPTX 195 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Spine Research UnitVall D’Hebron Research InstituteBarcelonaSpain
  2. 2.Department of Orhtopaedics and TraumatologyHospital Universitario Donostia, Servicio de Cirugía Ortopédica Y TraumatologíaDonostia/San SebastiánSpain
  3. 3.Spine Surgery UnitVall d’Hebron University HospitalBarcelonaSpain
  4. 4.Department of Orthopaedics and TraumatologyAcibadem Mehmet Ali Aydinlar UniversityIstanbulTurkey
  5. 5.Ankara ARTES Spine CenterAnkaraTurkey
  6. 6.Spine Surgery UnitBordeaux University HospitalBordeauxFrance
  7. 7.Spine Surgery UnitHospital La PazMadridSpain
  8. 8.Spine Center DivisionSchulthess KlinikZurichSwitzerland

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