The Management and Prevention of Complications
Spinal osteotomy for kyphotic deformity of ankylosing spondylitis (AS) has high risk due to large trauma, long operation time, and high difficulty of operation. It has been reported the incidence of complications is up to 40% [1, 2]. To manage and prevent complications is also crucial to the success of surgery. The complications are divided into intraoperative complications and postoperative complications. The former includes pedicle screw misplacement, blood loss, dura laceration/cerebrospinal fluid leakage, neurovascular injury, blindness, and sagittal translation [2–4]. The latter includes internal fixation failure, infection, pseudarthrosis, loss of correction, proximal junctional kyphosis/failure, and complications caused by changes in the volume of thoracic and abdominal cavity [3, 5–7]. With enhancement of ideas and techniques of spinal osteotomy, the effect of surgical correction for spinal kyphosis of AS has been greatly improved. The incidence of complications of pseudarthrosis and loss of correction is decreasing gradually. Instead, the reports for nerve injury and blood loss are increasing. Foreseeing the complications and comprehending how to prevent them can make the surgeons more confident, resulting in a better consequence for the patients .