Perioperative Morbidity and Mortality After Anterior, Posterior, and Anterior/Posterior Spine Fusion Surgery

Memtsoudis, Stavros G.; Vougioukas, Vassilios I.; Ma, Yan; Gaber-Baylis, Licia K.; Girardi, Federico P.

doi:10.1097/brs.0b013e3181c7decc

Cited by 105 publications

(77 citation statements)

References 28 publications

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“…Patellar clunk (12.2%) and infection (12.0%) provided the second and third most common indications for reoperation, respectively (Fig. 1 15 ORIFs for periprosthetic fractures (3.5%; 14 knees), 11 fasciotomies for compartment syndromes (2.5%; four knees), two synovectomies for synovitis (0.5%; two knees), and one procedure each for removal of osteophytes, removal of loose bodies, relief of patellofemoral impingement, and correction of poor patellar tracking (0.23%).…”

Section: Resultsmentioning

confidence: 99%

Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

Zmistowski

Restrepo

Kahl

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Section: Resultsmentioning

confidence: 99%

Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

Zmistowski

Restrepo

Kahl

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…In this study, incidence of blood loss/transfusion and durotomy were not examined (8). In a study of 261,356 patients undergoing thoracolumbar spinal fusion from the USA National Inpatient Sample database, Memtsoudis et al reported that anterior and anterior-posterior fusions were associated with significantly higher complication rates than posterior fusions despite anterior approaches being employed in younger and healthier populations (9). However, in this study, incidence of post-hemorrhagic anemia and need for blood transfusions were significantly reduced in anterior spinal fusions compared to posterior and combined anterior-posterior approaches (9).…”

Section: Discussionmentioning

confidence: 96%

“…In a study of 261,356 patients undergoing thoracolumbar spinal fusion from the USA National Inpatient Sample database, Memtsoudis et al reported that anterior and anterior-posterior fusions were associated with significantly higher complication rates than posterior fusions despite anterior approaches being employed in younger and healthier populations (9). However, in this study, incidence of post-hemorrhagic anemia and need for blood transfusions were significantly reduced in anterior spinal fusions compared to posterior and combined anterior-posterior approaches (9). Similarly, while Goz et al reported a higher mortality rate for anterior approaches to lumbar interbody fusion compared to posterior approaches, this study also reported greater incidence of neural complications (i.e., durotomy) and acute anemia secondary to hemorrhage with posterior approaches (10).…”

Section: Discussionmentioning

confidence: 99%

Impact of surgical approach on complication rates after elective spinal fusion (≥3 levels) for adult spine deformity

Elsamadicy¹,

Adogwa²,

Behrens³

et al. 2017

J. Spine Surg.

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Background: While there are variations in techniques and surgical approaches to spinal fusion, there is not a defined consensus on a recommended surgical approach. The aim of this study is to determine if there was a difference in intra-and post-operative complication rates between different surgical approaches after elective spinal fusion (≥3 levels) for adult spine deformity. Conclusions: Our study suggests that posterior approaches to spinal fusion may lead to a higher incidence of complications compared to anterior or combined anterior/posterior approaches.

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“…Irrespectively, the increasing number of spine fusion surgeries in an aging population with more comorbid burden means that the absolute number of mortalities is likely to increase. It should be mentioned, that posterior lumbar fusions are associated with lower mortality risk than for example anterior or thoracic approaches and that these data cannot be extrapolated to other spine surgical procedures [17].…”

Section: Discussionmentioning

confidence: 99%

Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors

Pumberger

Chiu

et al. 2012

Eur Spine J

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Study design Analysis of the Nationwide Inpatient Sample (NIS) from 1998 to 2008.Objective To analyze the most recent available and nationally representative data for risk factors contributing to in-hospital mortality after primary lumbar spine fusion. Summary of background data The total number of lumbar spine fusion surgeries has increased dramatically over the past decades. While the field of spine fusion surgery remains highly dynamic with changes in perioperative care constantly affecting patient care, recent data affecting rates and risk for perioperative mortality remain very limited. Methods We obtained the NIS from the Hospital cost and utilization project. The impact of patient and health care system related demographics, including various comorbidities as well as postoperative complications on the outcome of in-hospital mortality after spine fusion were studied. Furthermore, we analyzed the timing of in-hospital mortality.Results An estimated total of 1,288,496 primary posterior lumbar spine fusion procedures were performed in the US between 1998 and 2008. The average mortality rate for lumbar spine fusion surgery was 0.2 %. Independent risk factors for in-hospital mortality included advanced age, male gender, large hospital size, and emergency admission. Comorbidities associated with the highest in-hospital mortality after lumbar spine fusion surgery were coagulopathy, metastatic cancer, congestive heart failure and renal disease. Most lethal complications were cerebrovascular events, sepsis and pulmonary embolism. Furthermore, we demonstrated that the timing of death occurred relatively early in the in-hospital period with over half of fatalities occurring by postoperative day 9. Conclusion This study provides nationally representative information on risk factors for and timing of perioperative mortality after primary lumbar spine fusion surgery. These data can be used to assess risk for this event and to develop targeted intervention to decrease such risk.

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Perioperative Morbidity and Mortality After Anterior, Posterior, and Anterior/Posterior Spine Fusion Surgery

Cited by 105 publications

References 28 publications

Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

Incidence and Reasons for Nonrevision Reoperation After Total Knee Arthroplasty

Impact of surgical approach on complication rates after elective spinal fusion (≥3 levels) for adult spine deformity

Perioperative mortality after lumbar spinal fusion surgery: an analysis of epidemiology and risk factors

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