Abstract
Modern techniques facilitate the treatment of adult spinal deformity. Decision making is a challenge because of potential complications relating to the surgery itself and medical problems. This study aims to provide useful data in facilitating the decision making process.
Retrospective analysis of consecutive single surgeon series of patients aged >50 between 2006-2009 undergoing multi-level spinal deformity surgery with concomitant decompression. Medical co-morbidities, age and ASA were recorded.
71 patients (57 female) mean age 66 (50-83). 29 (12 multiple) failed previous stenosis surgery. 14(19.7%) in hospital complications in 11(15.5%) patients. 4 were ‘medical’. 8/11 patients were revision cases versus 3/11 primary. 4 patients (5.6%) needed further surgery. 13(18.3%) outpatient complications in 12(16.9%)patients. 7/12 occurred in revision cases versus 5/12 in primary. 11(15.5%) needed further surgery.
Revisional surgery in adult deformity presents a significantly higher overall complication rate than primary surgery (p= 0.0084), but both revisional and primary cases have a relatively high re-operation rate once initially discharged. The results indicate that complex medical and surgical factors contribute to the decision making challenge in patients with adult spinal deformity and stenosis.
