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A Comprehensive Review of Complication Rates After Surgery for Adult Deformity: A Reference for Informed Consent

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Abstract

Objective

An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making.

Methods

A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case—control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy).

Results

Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25–77 years), mean follow-up was 3.49 years (range: 6 weeks–9.7 years), estimated blood loss was 2,161 mL (range: 717–7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy.

Conclusions

A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent. © 2015 Scoliosis Research Society.

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References

  1. Ali RM, Boachie-Adjei O, Rawlins BA. Functional and radio-graphic outcomes after surgery for adult scoliosis using third-generation instrumentation techniques. Spine (Phila Pa 1976) 2003;28: 1163e9; discussion 1169e70.

    Google Scholar 

  2. Bradford DS. Adult scoliosis. Current concepts of treatment. Clin Orthop Relat Res 1988:70e87.

    Google Scholar 

  3. Dickson JH, Mirkovic S, Noble PC, et al. Results of operative treatment of idiopathic scoliosis in adults. J Bone Joint Surg Am 1995;77: 513e23.

    Article  Google Scholar 

  4. Jackson RP, Simmons EH, Stripinis D. Incidence and severity of back pain in adult idiopathic scoliosis. Spine (Phila Pa 1976) 1983;8: 749e56.

    Article  Google Scholar 

  5. Aebi M. The adult scoliosis. Eur Spine J 2005;14: 925e48.

    Article  Google Scholar 

  6. Blondel B, Schwab F, Ungar B, et al. Impact of magnitude and percentage of global sagittal plane correction on health-related quality of life at 2-years follow-up. Neurosurgery 2012;71: 341e8; discussion 348.

    Article  Google Scholar 

  7. Bridwell KH, Glassman S, Horton W, et al. Does treatment (nonop-erative and operative) improve the two-year quality of life in patients with adult symptomatic lumbar scoliosis: a prospective multicenter evidence-based medicine study. Spine (Phila Pa 1976) 2009;34: 2171e8.

    Article  Google Scholar 

  8. Hassanzadeh H, Jain A, El Dafrawy MH, et al. Clinical results and functional outcomes of primary and revision spinal deformity surgery in adults. J Bone Joint Surg Am 2013;95: 1413e9.

    Article  Google Scholar 

  9. Good CR, Lenke LG, Bridwell KH, et al. Can posterior-only surgery provide similar radiographic and clinical results as combined anterior (thoracotomy/thoracoabdominal)/posterior approaches for adult scoliosis? Spine (Phila Pa 1976) 2010;35: 210e8.

    Article  Google Scholar 

  10. Hassanzadeh H, Jain A, El Dafrawy MH, et al. Three-column osteotomies in the treatment of spinal deformity in adult patients 60 years old and older: outcome and complications. Spine (Phila Pa 1976) 2013;38: 726e31.

    Article  Google Scholar 

  11. Okuda S, Oda T, Yamasaki R, et al. Surgical outcomes of osteopo-rotic vertebral collapse: a retrospective study of anterior spinal fusion and pedicle subtraction osteotomy. Global Spine J 2012;2: 221e6.

    Article  Google Scholar 

  12. Chang KW, Chen YY, Lin CC, et al. Closing wedge osteotomy versus opening wedge osteotomy in ankylosing spondylitis with thoracolumbar kyphotic deformity. Spine (Phila Pa 1976) 2005;30: 1584e93.

    Google Scholar 

  13. Sponseller PD, Cohen MS, Nachemson AL, et al. Results of surgical treatment of adults with idiopathic scoliosis. J Bone Joint Surg Am 1987;69: 667e75.

    Article  Google Scholar 

  14. Weiss HR, Goodall D. Rate of complications in scoliosis surgeryda systematic review of the PubMed literature. Scoliosis 2008;3:9.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yadla S, Maltenfort MG, Ratliff JK, Harrop JS. Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus 2010;28:E3.

    Article  Google Scholar 

  16. Glassman SD, Hamill CL, Bridwell KH, et al. The impact of peri-operative complications on clinical outcome in adult deformity surgery. Spine (Phila Pa 1976) 2007;32: 2764e70.

    Google Scholar 

  17. Zeng Y, Chen Z, Guo Z, et al. Complications of correction for focal kyphosis after posterior osteotomy and the corresponding management. J Spinal Disord Tech 2013;26: 367e74.

    Google Scholar 

  18. Levels of Evidence for Primary Research Question. North American Spine Society. Available at: http://www.spine.org/Documents/LevelsofEvidenceFinal.pdf; 2005. Accessed October 27, 2014.

    Google Scholar 

  19. Acosta Jr FL, McClendon Jr J, O’shaughnessy BA, et al. Morbidity and mortality after spinal deformity surgery in patients 75 years and older: complications and predictive factors. J Neurosurg Spine 2011;15: 667e74.

    Google Scholar 

  20. Ahn UM, Ahn NU, Buchowski JM, et al. Functional outcome and radiographic correction after spinal osteotomy. Spine (Phila Pa 1976) 2002;27: 1303e11.

    Google Scholar 

  21. Arun R, Dabke HV, Mehdian H. Comparison of three types of lumbar osteotomy for ankylosing spondylitis: a case series and evolution of a safe technique for instrumented reduction. Eur Spine J 2011;20: 2252e60.

    Article  Google Scholar 

  22. Berven SH, Deviren V, Smith JA, et al. Management of fixed sagittal plane deformity: results of the transpedicular wedge resection osteotomy. Spine (Phila Pa 1976) 2001;26: 2036e43.

    Article  Google Scholar 

  23. Berven SH, Deviren V, Mitchell B, et al. Operative management of degenerative scoliosis: an evidence-based approach to surgical strategies based on clinical and radiographic outcomes. Neurosurg Clin N Am 2007;18: 261e72.

    Google Scholar 

  24. Bess RS, Lenke LG, Bridwell KH, et al. Comparison of thoracic pedicle screw to hook instrumentation for the treatment of adult spinal deformity. Spine (Phila Pa 1976) 2007;32: 555e61.

    Article  Google Scholar 

  25. Bess S, Line BG, Lafarge V, et al. Does recombinant human bone morphogenetic protein-2 (rhBMP-2) use in adult spinal deformity (ASD) increase complications and are complications associated with location of rhBMP-2 use?: a prospective, multicenter study of 279 consecutive patients. Spine (Phila Pa 1976) 2013.

    Google Scholar 

  26. Bezer M, Kucukdurmaz F, Guven O. Transpedicular decancellation osteotomy in the treatment of posttuberculous kyphosis. J Spinal Disord Tech 2007;20: 209e15.

    Article  Google Scholar 

  27. Bhagat S, Vozar V, Lutchman L, et al. Morbidity and mortality in adult spinal deformity surgery: Norwich Spinal Unit experience. Eur Spine J 2013;22(suppl 1):S42e6.

    Google Scholar 

  28. Boachie-Adjei O, Ferguson JA, Pigeon RG, Peskin MR. Transpedic-ular lumbar wedge resection osteotomy for fixed sagittal imbalance: surgical technique and early results. Spine (Phila Pa 1976) 2006;31: 485e92.

    Article  Google Scholar 

  29. Boachie-Adjei O, Charles G, Cunningham ME. Partially overlapping limited anterior and posterior instrumentation for adult thora-columbar and lumbar scoliosis: a description of novel spinal instrumentation, “the hybrid technique”. HSS J 2007;3: 93e8.

    Article  Google Scholar 

  30. Bridwell KH, Lewis SJ, Edwards C, et al. Complications and outcomes of pedicle subtraction osteotomies for fixed sagittal imbalance. Spine (Phila Pa 1976) 2003;28: 2093e101.

    Article  Google Scholar 

  31. Bridwell KH, Lewis SJ, Lenke LG, et al. Pedicle subtraction osteotomy for the treatment of fixed sagittal imbalance. J Bone Joint Surg Am 2003;85eA:454e63.

    Google Scholar 

  32. Brodano GB, Terzi S, Gasbarrini A, et al. Do benefits overcome the risks related to surgery for adult scoliosis? A detailed analysis of a consecutive case series. Eur Spine J 2013;22(suppl 6):S795e802.

    Google Scholar 

  33. Buchowski JM, Bridwell KH, Lenke LG, et al. Neurologic complications of lumbar pedicle subtraction osteotomy: a 10-year assessment. Spine (Phila Pa 1976) 2007;32: 2245e52.

    Article  Google Scholar 

  34. Chang KW, Chen YY, Lin CC, et al. Apical lordosating osteotomy and minimal segment fixation for the treatment of thoracic or thoracolum-bar osteoporotic kyphosis. Spine (Phila Pa 1976) 2005;30: 1674e81.

    Google Scholar 

  35. Chang KW, Cheng CW, Chen HC, et al. Closing-opening wedge osteotomy for the treatment of sagittal imbalance. Spine (Phila Pa 1976) 2008;33: 1470e7.

    Google Scholar 

  36. Charosky S, Guigui P, Blamoutier A, et al; Study Group on Scoli-osis. Complications and risk factors of primary adult scoliosis surgery: a multicenter study of 306 patients. Spine (Phila Pa 1976) 2012;37: 693e700.

    Article  Google Scholar 

  37. Chen IH, Chien JT, Yu TC. Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis: experience with 78 patients. Spine (Phila Pa 1976) 2001;26: E354e60.

    Article  Google Scholar 

  38. Chen Z, Yi H, Li M, et al. Associations between body mass and the outcome of surgery for scoliosis in Chinese adults. PLoS One 2011;6:e21601.

    Article  CAS  Google Scholar 

  39. Cho KJ, Bridwell KH, Lenke LG, et al. Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance. Spine (Phila Pa 1976) 2005;30: 2030e7; discussion 2038.

    Article  Google Scholar 

  40. Cho KJ, Suk SI, Park SR, et al. Complications in posterior fusion and instrumentation for degenerative lumbar scoliosis. Spine (Phila Pa 1976) 2007;32: 2232e7.

    Article  Google Scholar 

  41. Cho KJ, Suk SI, Park SR, et al. Short fusion versus long fusion for degenerative lumbar scoliosis. Eur Spine J 2008;17: 650e6.

    Article  Google Scholar 

  42. Cho SK, Bridwell KH, Lenke LG, et al. Major complications in revision adult deformity surgery: risk factors and clinical outcomes with 2- to 7-year follow-up. Spine (Phila Pa 1976) 2012;37: 489e500.

    Google Scholar 

  43. Cho SK, Bridwell KH, Lenke LG, et al. Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. Spine (Phila Pa 1976) 2012;37: 393e401.

    Google Scholar 

  44. Cho KJ, Kim KT, Kim WJ, et al. Pedicle subtraction osteotomy in elderly patients with degenerative sagittal imbalance. Spine (Phila Pa 1976) 2013;38:E1561e6.

    Article  Google Scholar 

  45. Daubs MD, Lenke LG, Cheh G, et al. Adult spinal deformity surgery: complications and outcomes in patients over age 60. Spine (Phila Pa 1976) 2007;32: 2238e44.

    Article  Google Scholar 

  46. Deviren V, Patel VV, Metz LN, et al. Anterior arthrodesis with instrumentation for thoracolumbar scoliosis: comparison of efficacy in adults and adolescents. Spine (Phila Pa 1976) 2008;33: 1219e23.

    Article  Google Scholar 

  47. DeWald CJ, Stanley T. Instrumentation-related complications of multilevel fusions for adult spinal deformity patients over age 65: surgical considerations and treatment options in patients with poor bone quality. Spine (Phila Pa 1976) 2006;31:S144e51.

    Article  Google Scholar 

  48. Eck KR, Bridwell KH, Ungacta FF, et al. Complications and results of long adult deformity fusions down to L4, L5, and the sacrum. Spine (Phila Pa 1976) 2001;26:E182e92.

    Article  Google Scholar 

  49. Edwards 2nd CC, Bridwell KH, Patel A, et al. Thoracolumbar deformity arthrodesis to L5 in adults: the fate of the L5-S1 disc. Spine (Phila Pa 1976) 2003;28: 2122e31.

    Article  Google Scholar 

  50. El-Sharkawi MM, Koptan WM, El-Miligui YH, Said GZ. Comparison between pedicle subtraction osteotomy and anterior corpec-tomy and plating for correcting post-traumatic kyphosis: a multicenter study. Eur Spine J 2011;20: 1434e40.

    Article  Google Scholar 

  51. Emami A, Deviren V, Berven S, et al. Outcome and complications of long fusions to the sacrum in adult spine deformity: Luque-Galveston, combined iliac and sacral screws, and sacral fixation. Spine (Phila Pa 1976) 2002;27: 776e86.

    Article  Google Scholar 

  52. Finocchiaro FM, Nena U, Lo Scalzo V, Monterumici DA. Treatment of kyphotic deformities in adults: our experience. Eur Spine J 2012;21(suppl 1):S100e7.

    Google Scholar 

  53. Gavaskar AS, Naveen Chowdary T. Pedicle subtraction osteotomy for rigid kyphosis of the dorsolumbar spine. Arch Orthop Trauma Surg 2011;131: 803e8.

    Article  Google Scholar 

  54. Glattes RC, Bridwell KH, Lenke LG, et al. Proximal junctional kyphosis in adult spinal deformity following long instrumented posterior spinal fusion: incidence, outcomes, and risk factor analysis. Spine (Phila Pa 1976) 2005;30: 1643e9.

    Article  Google Scholar 

  55. Hyun SJ, Rhim SC. Clinical outcomes and complications after pedicle subtraction osteotomy for fixed sagittal imbalance patients: a long-term follow-up data. J Korean Neurosurg Soc 2010;47: 95e101.

    Google Scholar 

  56. Ikenaga M, Shikata J, Takemoto M, Tanaka C. Clinical outcomes and complications after pedicle subtraction osteotomy for correction of thoracolumbar kyphosis. J Neurosurg Spine 2007;6: 330e6.

    Article  Google Scholar 

  57. Jang JS, Lee SH, Min JH, et al. Surgical treatment of failed back surgery syndrome due to sagittal imbalance. Spine (Phila Pa 1976) 2007;32: 3081e7.

    Google Scholar 

  58. Jang JS, Lee SH, Kim JM, et al. Can patients with sagittally well-compensated lumbar degenerative kyphosis benefit from surgical treatment for intractable back pain? Neurosurgery 2009;64: 115e21; discussion 121.

    Article  Google Scholar 

  59. Kasliwal MK, Smith JS, Shaffrey CI, et al. Does prior short-segment surgery for adult scoliosis impact perioperative complication rates and clinical outcome among patients undergoing scoliosis correction? J Neurosurg Spine 2012;17: 128e33.

    Article  Google Scholar 

  60. Kasten MD, Rao LA, Priest B. Long-term results of iliac wing fixation below extensive fusions in ambulatory adult patients with spinal disorders. J Spinal Disord Tech 2010;23:e37e42.

    Article  Google Scholar 

  61. Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in primary fusions for adult idiopathic scoliosis: incidence, risk factors, and outcome analysis. Spine (Phila Pa 1976) 2005;30: 468e74.

    Google Scholar 

  62. Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in adult spinal deformity following multisegmental instrumentation and arthrodesis. J Bone Joint Surg Am 2006;88: 721e8.

    Google Scholar 

  63. Kim YJ, Bridwell KH, Lenke LG, et al. Pseudarthrosis in long adult spinal deformity instrumentation and fusion to the sacrum: prevalence and risk factor analysis of 144 cases. Spine (Phila Pa 1976) 2006;31: 2329e36.

    Google Scholar 

  64. Kim YJ, Bridwell KH, Lenke LG, et al. Results of lumbar pedicle subtraction osteotomies for fixed sagittal imbalance: a minimum 5-year follow-up study. Spine (Phila Pa 1976) 2007;32: 2189e97.

    Google Scholar 

  65. Kim KT, Lee SH, Suk KS, et al. Spinal pseudarthrosis in advanced ankylosing spondylitis with sagittal plane deformity: clinical characteristics and outcome analysis. Spine (Phila Pa 1976) 2007;32: 1641e7.

    Google Scholar 

  66. Kim YB, Lenke LG, Kim YJ, et al. Surgical treatment of adult scoli-osis: is anterior apical release and fusion necessary for the lumbar curve? Spine (Phila Pa 1976) 2008;33: 1125e32.

    Google Scholar 

  67. Lapp MA, Bridwell KH, Lenke LG, et al. Long-term complications in adult spinal deformity patients having combined surgery a comparison of primary to revision patients. Spine (Phila Pa 1976) 2001;26: 973e83.

    Google Scholar 

  68. Lenke LG, Sides BA, Koester LA, et al. Vertebral column resection for the treatment of severe spinal deformity. Clin Orthop Relat Res 2010;468: 687e99.

    Article  Google Scholar 

  69. Lenke LG, Fehlings MG, Shaffrey CI, et al. Prospective, multicenter assessment of acute neurologic complications following complex adult spinal deformity surgery: the Scoli-Risk-1 Trial. Spine J 2013;13:S67.

    Article  Google Scholar 

  70. Li G, Passias P, Kozanek M, et al. Adult scoliosis in patients over sixty-five years of age: outcomes of operative versus nonoperative treatment at a minimum two-year follow-up. Spine (Phila Pa 1976) 2009;34: 2165e70.

    Google Scholar 

  71. Norton RP, Bianco K, Lafage V, Schwab FJ. International Spine Study Group Foundation. Complications and intercenter variability of three-column resection osteotomies for spinal deformity surgery: a retrospective review of 423 patients. Evid Based Spine Care J 2013;4: 157e9.

    Google Scholar 

  72. Ohtori S, Sainoh T, Takaso M, et al. Clinical incidence of sacroiliac joint arthritis and pain after sacropelvic fixation for spinal deformity. Yonsei Med J 2012;53: 416e21.

    Google Scholar 

  73. O’shaughnessy BA, Kuklo TR, Hsieh PC, et al. Thoracic pedicle subtraction osteotomy for fixed sagittal spinal deformity. Spine (Phila Pa 1976) 2009;34: 2893e9.

    Article  Google Scholar 

  74. Park YS, Kim HS, Baek SW. Spinal osteotomy in ankylosing spon-dylitis: radiological, clinical, and psychological results. Spine J 2014;14: 1921e7.

    Google Scholar 

  75. Pateder DB, Gonzales RA, Kebaish KM, et al. Short-term mortality and its association with independent risk factors in adult spinal deformity surgery. Spine (Phila Pa 1976) 2008;33: 1224e8.

    Google Scholar 

  76. Pateder DB, Gonzales RA, Kebaish KM, et al. Pulmonary embolism after adult spinal deformity surgery. Spine (Phila Pa 1976) 2008;33: 301e5.

    Google Scholar 

  77. Peelle MW, Boachie-Adjei O, Charles G, et al. Lumbar curve response to selective thoracic fusion in adult idiopathic scoliosis. Spine J 2008;8: 897e903.

    Article  Google Scholar 

  78. Ploumis A, Albert TJ, Brown Z, et al. Healos graft carrier with bone marrow aspirate instead of allograft as adjunct to local autograft for posterolateral fusion in degenerative lumbar scoliosis: a minimum 2-year follow-up study. J Neurosurg Spine 2010;13: 211e5.

    Article  Google Scholar 

  79. Qian BP, Qiu Y, Wang B, et al. Pedicle subtraction osteotomy through pseudarthrosis to correct thoracolumbar kyphotic deformity in advanced ankylosing spondylitis. Eur Spine J 2012;21: 711e8.

    Google Scholar 

  80. Rhee JM, Bridwell KH, Lenke LG, et al. Staged posterior surgery for severe adult spinal deformity. Spine (Phila Pa 1976) 2003;28: 2116e21.

    Article  Google Scholar 

  81. Rose PS, Lenke LG, Bridwell KH, et al. Pedicle screw instrumentation for adult idiopathic scoliosis: an improvement over hook/hybrid fixation. Spine (Phila Pa 1976) 2009;34: 852e7; discussion 858.

    Google Scholar 

  82. Sansur CA, Smith JS, Coe JD, et al. Scoliosis research society morbidity and mortality of adult scoliosis surgery. Spine (Phila Pa 1976) 2011;36:E593e7.

    Article  Google Scholar 

  83. Scheer JK, Lafage V, Smith JS, et al. Impact of age on the likelihood of reaching a minimum clinically important difference in 374 three-column spinal osteotomies: clinical article. J Neurosurg Spine 2014;20: 306e12.

    Article  Google Scholar 

  84. Shapiro GS, Taira G, Boachie-Adjei O. Results of surgical treatment of adult idiopathic scoliosis with low back pain and spinal stenosis: a study of long-term clinical radiographic outcomes. Spine (Phila Pa 1976) 2003;28: 358e63.

    Google Scholar 

  85. Smith JA, Deviren V, Berven S, Bradford DS. Does instrumented anterior scoliosis surgery lead to kyphosis, pseudarthrosis, or inadequate correction in adults? Spine (Phila Pa 1976) 2002;27: 529e34.

    Google Scholar 

  86. Smith JS, Sansur CA, Donaldson 3rd WF, et al. Short-term morbidity and mortality associated with correction of thoracolumbar fixed sagittal plane deformity: a report from the Scoliosis Research Society Morbidity and Mortality Committee. Spine (Phila Pa 1976) 2011;36: 958e64.

    Google Scholar 

  87. Suk SI, Kim JH, Kim WJ, et al. Posterior vertebral column resection for severe spinal deformities. Spine (Phila Pa 1976) 2002;27: 2374e82.

    Article  Google Scholar 

  88. Suk SI, Chung ER, Kim JH, et al. Posterior vertebral column resection for severe rigid scoliosis. Spine (Phila Pa 1976) 2005;30: 1682e7.

    Google Scholar 

  89. Suk SI, Chung ER, Lee SM, et al. Posterior vertebral column resection in fixed lumbosacral deformity. Spine (Phila Pa 1976) 2005;30: E703e10.

    Google Scholar 

  90. Takahashi S, Delecrin J, Passuti N. Surgical treatment of idiopathic scoliosis in adults: an age-related analysis of outcome. Spine (Phila Pa 1976) 2002;27: 1742e8.

    Article  Google Scholar 

  91. Toyone T, Shiboi R, Ozawa T, et al. Asymmetrical pedicle subtraction osteotomy for rigid degenerative lumbar kyphoscoliosis. Spine (Phila Pa 1976) 2012;37: 1847e52.

    Article  Google Scholar 

  92. Tsai TH, Huang TY, Lieu AS, et al. Functional outcome analysis: instrumented posterior lumbar interbody fusion for degenerative lumbar scoliosis. Acta Neurochir (Wien) 2011;153: 547e55.

    Article  Google Scholar 

  93. Wang ST, Ma HL, Lin CF, et al. Surgical treatment of adult idio-pathic scoliosisdcomparison of two instrumentations. Int Orthop 2002;26: 207e10.

    Article  Google Scholar 

  94. Wang Y, Zhang Y, Zhang X, et al. A single posterior approach for multilevel modified vertebral column resection in adults with severe rigid congenital kyphoscoliosis: a retrospective study of 13 cases. Eur Spine J 2008;17: 361e72.

    Google Scholar 

  95. Wang Y, Zhang Y, Zhang X, et al. Posterior-only multilevel modified vertebral column resection for extremely severe Pott’s kyphotic deformity. Eur Spine J 2009;18: 1436e41.

    Google Scholar 

  96. Wang Y, Zhang Y, Mao K, et al. Transpedicular bivertebrae wedge osteotomy and discectomy in lumbar spine for severe ankylosing spondylitis. J Spinal Disord Tech 2010;23: 186e91.

    Article  Google Scholar 

  97. Weistroffer JK, Perra JH, Lonstein JE, et al. Complications in long fusions to the sacrum for adult scoliosis: minimum five-year analysis of fifty patients. Spine (Phila Pa 1976) 2008;33: 1478e83.

    Article  Google Scholar 

  98. Wu CH, Wong CB, Chen LH, et al. Instrumented posterior lumbar interbody fusion for patients with degenerative lumbar scoliosis. J Spinal Disord Tech 2008;21: 310e5.

    Article  Google Scholar 

  99. Yagi M, Patel R, Boachie-Adjei O. Complications and unfavorable clinical outcomes in obese and overweight patients treated for adult lumbar or thoracolumbar scoliosis with combined anterior/posterior surgery. J Spinal Disord Tech 2013.

    Google Scholar 

  100. Yagi M, Patel R, Lawhorne TW, et al. Adult thoracolumbar and lumbar scoliosis treated with long vertebral fusion to the sacropel-vis: a comparison between new hybrid selective spinal fusion versus anterior-posterior spinal instrumentation. Spine J 2014;14: 637e45.

    Article  Google Scholar 

  101. Yang BP, Ondra SL, Chen LA, et al. Clinical and radiographic outcomes of thoracic and lumbar pedicle subtraction osteotomy for fixed sagittal imbalance. J Neurosurg Spine 2006;5: 9e17.

    Article  Google Scholar 

  102. Zhang XS, Zhang YG, Wang Z, et al. Correction of severe post-traumatic kyphosis by posterior vertebra column resection. Chin Med J (Engl) 2010;123: 680e5.

    Google Scholar 

  103. Zhang HQ, Huang J, Guo CF, et al. Two-level pedicle subtraction osteotomy for severe thoracolumbar kyphotic deformity in anky-losing spondylitis. Eur Spine J 2014;23: 234e41.

    Google Scholar 

  104. Zhu Z, Wang X, Qian B, et al. Loss of correction in the treatment of thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison between Smith-Petersen osteotomies and pedicle subtraction osteotomy. J Spinal Disord Tech 2012;25: 383e90.

    Google Scholar 

  105. Zimmerman RM, Mohamed AS, Skolasky RL, et al. Functional outcomes and complications after primary spinal surgery for scoliosis in adults aged forty years or older: a prospective study with minimum two-year follow-up. Spine (Phila Pa 1976) 2010;35: 1861e6.

    Article  Google Scholar 

  106. Bradford DS, Tay BK, Hu SS. Adult scoliosis: surgical indications, operative management, complications, and outcomes. Spine (Phila Pa 1976) 1999;24: 2617e29.

    Google Scholar 

  107. Schwab F, Ungar B, Blondel B, et al. Scoliosis Research Society-Schwab adult spinal deformity classification: a validation study. Spine (Phila Pa 1976) 2012;37: 1077e82.

    Article  Google Scholar 

  108. Lippman CR, Spence CA, Youssef AS, Cahill DW. Correctionofadult scoliosis via a posterior-only approach. Neurosurg Focus 2003;14:e5.

    Article  Google Scholar 

  109. Bago J, Perez-Grueso FJ, Les E, et al. Minimal important differences of the SRS-22 Patient Questionnaire following surgical treatment of idiopathic scoliosis. Eur Spine J 2009;18: 1898e904.

    Article  Google Scholar 

  110. Bridwell KH, Baldus C, Berven S, et al. Changes in radiographic and clinical outcomes with primary treatment adult spinal deformity surgeries from two years to three- to five-years follow-up. Spine (Phila Pa 1976) 2010;35: 1849e54.

    Article  Google Scholar 

  111. Smith JS, Shaffrey CI, Berven S, et al. Improvement of back pain with operative and nonoperative treatment in adults with scoliosis. Neurosurgery 2009;65: 86e93; discussion 93e4.

    Article  Google Scholar 

  112. Smith JS, Shaffrey CI, Berven S, et al. Operative versus nonopera-tive treatment of leg pain in adults with scoliosis: a retrospective review of a prospective multicenter database with two-year follow-up. Spine (Phila Pa 1976) 2009;34: 1693e8.

    Article  Google Scholar 

  113. Hamilton DK, Smith JS, Nguyen T, et al. Sexual function in older adults following thoracolumbar to pelvic instrumentation for spinal deformity. J Neurosurg Spine 2013;19: 95e100.

    Article  Google Scholar 

  114. Winter RB, Lonstein JE, Denis F. Pain patterns in adult scoliosis. Orthop Clin North Am 1988;19: 339e45.

    Google Scholar 

  115. Auerbach JD, Lenke LG, Bridwell KH, et al. Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine (Phila Pa 1976) 2012;37: 1198e210.

    Google Scholar 

  116. Bridwell KH. Decision making regarding Smith-Petersen vs. pedicle subtraction osteotomy vs. vertebral column resection for spinal deformity. Spine (Phila Pa 1976) 2006;31:S171e8.

    Article  Google Scholar 

  117. Baron EM, Albert TJ. Medical complications of surgical treatment of adult spinal deformity and how to avoid them. Spine (Phila Pa 1976) 2006;31:S106e18.

    Article  Google Scholar 

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  1. Department of Neurosurgery, The Johns Hopkins Hospital, 600 North Wolfe Street; Meyer Building, Room 7-109, 600 N. Wolfe St, Meyer 5-185, Baltimore, MD, 21287, USA

    Daniel M. Sciubba MD, Alp Yurter BS & C. Rory Goodwin MD, PhD

  2. Department of Neurosurgery, University of Virginia Health System, 1215 Lee St, Charlottesville, VA, 22903, USA

    Justin S. Smith MD, PhD & Christopher I. Shaffrey MD

  3. Department of Orthopedic Surgery, Washington University, 4921 Parkview Place, A 12, St. Louis, MO, 63110, USA

    Michael P. Kelly MD

  4. Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 North St. Clair Street, Suite 2210, Chicago, IL, 60611, USA

    Justin K. Scheer BS

  5. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, 306 E 15th Street, Suite 1F, New York, NY, 10003, USA

    Virginie Lafage PhD & Frank Schwab MD

  6. Department of Orthopaedic Surgery, Oregon Health & Science University, 3182 SW Sam Jackson Park Rd; Ortho Dept MC: OP31, Portland, OR, 97239, USA

    Robert A. Hart MD

  7. Rocky Mountain Hospital for Children, 2055 High Street, Suite 130, Denver, CO, 80205, USA

    Shay Bess MD

  8. Department of Orthopaedic Surgery, Johns Hopkins University, 610 North Caroline Street, Suite 5243, Baltimore, MD, 21287, USA

    Khaled Kebaish MD

  9. Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave, M779 — Department of Neurosurgery, San Francisco, CA, 94143, USA

    Christopher P. Ames MD

Authors
  1. Daniel M. Sciubba MD
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  2. Alp Yurter BS
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  3. Justin S. Smith MD, PhD
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  4. Michael P. Kelly MD
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  5. Justin K. Scheer BS
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  6. C. Rory Goodwin MD, PhD
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  7. Virginie Lafage PhD
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  8. Robert A. Hart MD
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  9. Shay Bess MD
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  10. Khaled Kebaish MD
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  11. Frank Schwab MD
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  12. Christopher I. Shaffrey MD
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  13. Christopher P. Ames MD
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Consortia

The International Spine Study Group (ISSG)

Corresponding author

Correspondence to Daniel M. Sciubba MD.

Additional information

Author disclosures: DMS (none), AY (none), JSS (none), MPK (none), JKS (none), CRG (grants from UNCF-Merck Science Initiative, grants from NREF, grants from Burroughs Wellcome Fund, outside the submitted work), VL (none), RAH (none), SB (none), KK (none), FS (none), CIS (none), CPA (none).

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Sciubba, D.M., Yurter, A., Smith, J.S. et al. A Comprehensive Review of Complication Rates After Surgery for Adult Deformity: A Reference for Informed Consent. Spine Deform 3, 575–594 (2015). https://doi.org/10.1016/j.jspd.2015.04.005

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  • DOI: https://doi.org/10.1016/j.jspd.2015.04.005

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