Japanese 2011 nationwide survey on complications from spine surgery

Abstract

BackgroundThe Japanese Society for Spine Surgery and Related Research (JSSR) previously carried out two nationwide surveys in 1994 and 2001 on complications from spine and spinal cord surgery. More than 10 years have now elapsed since 2001. Rapidly ageing populations have major impacts on society, particularly in the medical field. The purpose of this study was therefore to examine the present situation for spine surgery in Japan.MethodsThe JSSR research team prepared a computerized questionnaire made up of two categories in order to capture clinicopathological information and surgical information. A recordable optical disc for data storage was sent to surgeons who were certified for spine surgery by JSSR. The data was analyzed.ResultsThe JSSR carried out a nationwide survey of complications of 31,380 patients. Patients aged 60 years or older comprised 63.1 % of the overall cohort. This was considerably higher than observed in previous surveys. Degenerative spinal diseases increased 79.7 %. With regard to surgical approach, the incidence of anterior surgery has decreased, while that of posterior surgery has increased compared to the earlier surveys (both p < 0.05). Spinal instrumentation was applied in 30.2 % cases, compared to 27.0 and 34.0 % cases in the 1994 and 2001 surveys, respectively. Intraoperative and postoperative complications were reported in 10.4 % and were slightly increased compared to 8.6 % in the earlier surveys (both p < 0.05). Diseases associated with a high incidence of complication included intramedullary tumor (29.3 %) and primary malignant tumor (22.0 %). The highest incidence of complication was dural tear (2.1 %), followed by neurological complication (1.4 %).

A simple scoring system for predicting early major complications in spine surgery: the cumulative effect of age and size of surgery

“…A good example is offered by disk herniation, which generally fits into this description (one level, mostly young patients). In a 2011 review of the incidence of complications in 7,964 disk herniation surgeries performed by the Japanese Society for Spine Surgery and Related Research board certified surgeons, the incidence of complications was 5,6% 21 , which compares fairly well to our cohort. The balanced risk score ( Table 5) shows results that specify and quantify the intuitive perception of spine surgeons: small surgeries in young patients are accompanied by fewer major complications (7%) than large surgeries performed in older patients (29%).…”

“…Analyses of large cohorts usually show that these cases are accompanied by more complications 21 than those involving only posterior or anterior manipulation. In our material, 360° arthrodesis with interbody cages was also considered circumferential surgery because it also involves the "three columns", takes a longer time and bleeds more.…”

Surgical and general complications in 2,961 Japanese patients with cervical spondylotic myelopathy: Comparison of different age groups

“…Yasuaki Imajo 1) , Toshihiko Taguchi 1) , Masashi Neo 2) , Koji Otani 3) , Tadanori Ogata 4) , Hiroshi Ozawa…”

“…The primary data were obtained from a survey conducted by the JSSR in 2011 3) . Briefly, a research team prepared a computerized questionnaire to capture both clinicopathological and surgical information.…”

“…The JSSR performed nationwide surveys relating to spinal surgery and the associated complications in 1994, 2001, and 2011 [1][2][3] . Japan is a super-aging country.…”