BMC Musculoskeletal Disorders (May 2021)

Factors and predictive model associated with perioperative complications after long fusion in the treatment of adult non-degenerative scoliosis

  • Nan Wu,
  • Jiashen Shao,
  • Zhen Zhang,
  • Shengru Wang,
  • Ziquan Li,
  • Sen Zhao,
  • Yang Yang,
  • Lian Liu,
  • Chenxi Yu,
  • Sen Liu,
  • Zhengye Zhao,
  • You Du,
  • Yuanqiang Zhang,
  • Lianlei Wang,
  • Yu Zhao,
  • Keyi Yu,
  • Hong Zhao,
  • Jianxiong Shen,
  • Guixing Qiu,
  • Deciphering Disorders Involving Scoliosis and COmorbidities (DISCO) study,
  • Zhihong Wu,
  • Terry Jianguo Zhang

DOI
https://doi.org/10.1186/s12891-021-04361-y
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 9

Abstract

Read online

Abstract Introduction Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied. Methods We evaluated clinical and radiographical results from 146 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis. Results One hundred forty-six adult non-degenerative scoliosis patients were included in our study. There were 23 perioperative complications for 21 (14.4%) patients, eight of which were cardiopulmonary complications, two of which were infection, six of which were neurological complications, three of which were gastrointestinal complications, and four of which were incision-related complication. The independent risk factors for development of total perioperative complications included change in Cobb angle (odds ratio [OR] = 1.085, 95% CI = 1.035 ~ 1.137, P = 0.001) and spinal osteotomy (OR = 3.565, 95% CI = 1.039 ~ 12.236, P = 0.043). The independent risk factor for minor perioperative complications is change in Cobb angle (OR = 1.092, 95% CI = 1.023 ~ 1.165, P = 0.008). The independent risk factors for major perioperative complications are spinal osteotomy (OR = 4.475, 95% CI = 1.960 ~ 20.861, P = 0.036) and change in Cobb angle (OR = 1.106, 95% CI = 1.035 ~ 1.182, P = 0.003). Conclusions Our study indicate that change in Cobb angle and spinal osteotomy are independent risk factors for total perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients. Change in Cobb angle is an independent risk factor for minor perioperative complications. Change in Cobb angle and spinal osteotomy are independent risk factors for major perioperative complications.

Keywords