Complications following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study using the modified Clavien–Dindo–Sink system

Keil, Lukas G.; Himmelberg, Stephen M; Guissé, Ndéye F.; Nash, Alysa; Fletcher, Nicholas D.; Stone, Jennifer A.

doi:10.1007/s43390-021-00468-3

Cited by 7 publications

(16 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The modified Clavien-Dindo-Sink (CDS) classification has been validated to describe complications after spinal fusion for children with adolescent idiopathic scoliosis and cerebral palsy (CP). [10][11][12][13] Given the sparse and inconsistent data on early RS complications after PSF, our primary objective was to describe postoperative complications, readmissions, and reoperations using the modified CDS classification system. Secondarily, we also described preoperative and intraoperative characteristics, and compared patients fused and not fused to the pelvis.…”

mentioning

confidence: 99%

“…In 1992, Clavien et al9 described complications as unexpected events not intrinsic to the procedure and proposed a classification system that did not rely on “major” or “minor” as outcome measurements, thereby reducing subjectivity. The modified Clavien-Dindo-Sink (CDS) classification has been validated to describe complications after spinal fusion for children with adolescent idiopathic scoliosis and cerebral palsy (CP) 10–13. Given the sparse and inconsistent data on early RS complications after PSF, our primary objective was to describe postoperative complications, readmissions, and reoperations using the modified CDS classification system.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Early Complications After Posterior Spinal Fusion in Patients With Rett Syndrome

Taylor

Bridges

Nordstrom

et al. 2023

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background: Neuromuscular scoliosis in Rett syndrome (RS) is common, progressive, and often requires posterior spinal fusion (PSF). While PSF is associated with improved overall outcomes, there is a paucity of information describing complications. We aimed to report the postoperative complications, readmissions, and reoperations for patients with RS undergoing PSF. Methods: Female pediatric patients with RS treated by PSF with segmental instrumentation, with or without concurrent pelvis fixation, during January 2012 to August 2022 were included. Preoperative patient characteristics, intraoperative data (estimated blood loss, cell saver, packed red blood cells transfused), postoperative complications according to the Modified Clavien-Dindo-Sink classification within 90 days, unplanned readmissions within 30 days, and unplanned reoperations within 90 days were recorded. Results: A total of 25 females were included. The mean (SD) age at surgery was 12.9 (1.8) years and the mean follow-up of 38.6 (24.9) months. The mean preoperative major coronal curve was 79 degrees (23 degrees) which decreased to 32 degrees (15 degrees) by the last follow-up (P<0.001). The median estimated blood loss was 600 mL and length of stay was 7 days. There were 81 total postoperative complications (3.2 complications/patient). Eight (32%) had grade IVa complications (disseminated intravascular coagulopathy, hypotensive shock, respiratory failure, chronic urosepsis). Five (20%) patients experienced seizures, 48% had pulmonary complications, and 56% had gastrointestinal complications. There were 3 readmissions (12%) within 30 days for pneumonia and 2 (8%) reoperations (an incision and drainage and C2-T2 fusion for significant kyphosis) within 90 days. One patient also had their fusion extended to the pelvis 1 year later. There were more nonambulatory patients in the group fused to the pelvis, but otherwise no differences between those fused and unfused to the pelvis. Conclusions: This is the largest review of early postoperative complications for patients with RS who underwent PSF. PSF effectively reduced the major coronal curve, but surgeons and families should be aware of a high postoperative seizure and respiratory complication rate, as well as 8% having reoperations within 90 days and 12% being readmitted within 30 days. Level of Evidence: Level IV—therapeutic study.

show abstract

mentioning

confidence: 99%

mentioning

confidence: 99%

Early Complications After Posterior Spinal Fusion in Patients With Rett Syndrome

Taylor

Bridges

Nordstrom

et al. 2023

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…This study from Miyagi (Japan) investigated the association between sleep disturbance and LBP using longitudinal data collected in the period after the Great East Japan Earthquake (GEJE) that occurred in 2011. 2 The GEJE resulted in a stressful period for the survivors of this natural disaster with worsening socioeconomic conditions, and so forms a natural experiment for establishing if there is any association. This study analyzed sleep disturbance and LBP at four, five, six, and seven years after the GEJE using multiple logistic regression analysis.…”

Section: Arthrocentesis Arthroscopy or Arthrotomy For Septic Knee Art...mentioning

confidence: 99%

“…We were therefore interested to see this paper from Chapel Hill (North Carolina, USA) , which classifies and documents complications using the Clavien-Dindo-Sink (CDS) system, as well as investigating risk factors for the occurrence of a complication. 2 The study was performed at two university hospitals, and the cohort included all AIS patients aged between ten and 18 years who underwent primary posterior spinal fusion over a five-year period. Demographic details, comorbidities, and surgical details, including the magnitude of the curve, Lenke classification, and fusion levels, were collected, giving a well phenotyped cohort.…”

Section: Complications Following Posterior Spinal Fusion For Adolesce...mentioning

confidence: 99%

Children’s orthopaedics

2022

Bone & Joint 360

View full text Add to dashboard Cite

“…16 The mCDS system has previously been used to evaluate complications following PSF by Keil et al, providing data against which complications in AVBT can be compared. 19 The primary goal of this study is to analyze the complication rate of VBT in IS through the mCDS framework and compare it to this recently published study reporting on the mCDS system for complications in PSF for IS.…”

mentioning

confidence: 99%

A New Look at Vertebral Body Tethering (VBT): Through the Modified Clavien-Dindo-Sink (mCDS) Classification

Vorhies,

Hauth,

Garcia

et al. 2024

Journal of Pediatric Orthopaedics

Self Cite

View full text Add to dashboard Cite

Introduction: Anterior vertebral body tethering (AVBT) is increasingly popular as an option for surgical treatment of idiopathic scoliosis (IS). While the technology remains new, it is important for families and patients to be able to compare it to the current standard of care, posterior spinal fusion (PSF). The purpose of this study is to describe the complication rate of AVBT in IS using the mCDS and to compare it to the recently reported complication rate of PSF in IS. Methods: A multicenter pediatric spine deformity database was queried for all idiopathic scoliosis patients who underwent vertebral body tethering. There were 171 patients with a minimum 9-month follow-up included in this study. Complications were retrospectively graded by 2 attending pediatric spine surgeons using the mCDS classification system. Results: Data from 171 patients with idiopathic scoliosis was available for analysis, with 156/171 (91%) of patients being female and an average age of 12.2 years old at surgery. There were 156 thoracic tethers (1 with an LIV below L2), 5 lumbar tethers, 9 staged double tethers, and only 1 patient with same-day double tether. Fifty-five (55) (32%) patients experienced a total of 69 complications. The most common complication type for VBT by mCDS was Grade IIIb, encompassing 29/69 (42%) of complications. The second most frequent complication grade was Grade I at 23/69 (33%). Thirty-four (34) out of 69 (49%) of the VBT complications reported required either procedural/surgical intervention or admission to the ICU. Conclusions: This is the first study to directly compare the complication profile of VBT to PSF using the mCDS. Forty-nine percent (49%) of the VBT complications reported were at least Grade III, while only 7% of complications in the control PSF cohort from the literature were Grade III or higher. The mCDS complication classification brings light to the early learning experience of a new technique compared to the widely accepted standard of PSF for IS. Level of Evidence: III – Retrospective comparative study.

show abstract

Complications following posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective cohort study using the modified Clavien–Dindo–Sink system

Cited by 7 publications

References 31 publications

Early Complications After Posterior Spinal Fusion in Patients With Rett Syndrome

Early Complications After Posterior Spinal Fusion in Patients With Rett Syndrome

Children’s orthopaedics

A New Look at Vertebral Body Tethering (VBT): Through the Modified Clavien-Dindo-Sink (mCDS) Classification

Contact Info

Product

Resources

About