Complications of spinal fusion for scheuermann kyphosis: a report of the scoliosis research society morbidity and mortality committee.
METHODS
Retrospective review of a prospectively collected, multicentered database from the Scoliosis Research Society.


OBJECTIVE
To evaluate incidences of complications in a series of spinal fusions for Scheuermann kyphosis (SK) and to assess whether the incidence of complications is associated with patient age and surgical approach.


BACKGROUND
Although there is some evidence that adolescents have lower complication rates for spinal deformity surgery, this has not been well-documented for SK. Moreover, there is a lack of consensus on surgical approach for the management of SK.


METHODS
The Scoliosis Research Society morbidity and mortality database was queried to identify cases of SK from 2001 to 2004. Complications rates were analyzed based on patient age and surgical approach. Pediatric and adult patients were defined as <or=19 and >19 year old, respectively.


RESULTS
A total of 683 procedures involving spinal fusion for SK were identified. Mean patient age was 21 years (range: 5-75 years), with the majority (73%) of patients <or=19 years old. Procedures included 338 (49%) posterior spinal fusions (PSF), 73 (11%) anterior spinal fusions (ASF), and 272 (40%) same-day ASF and PSF. Ninety-nine complications were reported (14%). The most common complication was wound infection (3.8%). The acute neurologic complication rate was 1.9%, including 4 spinal cord injuries (0.6%). The mortality rate was 0.6%. Complications were more common among adult (22%) compared with pediatric patients (12%) (P = 0.002). The overall incidence of complications did not differ significantly between the PSF (14.8%) and same-day ASF/PSF (16.9%) procedures (P = 0.5).


CONCLUSIONS
The incidence of complications associated with spinal fusion for SK in adults is significantly greater than in pediatric patients. There were no significant differences in complication rates between PSF and same-day ASF/PSF procedures. These data may be used to counsel patients regarding complications associated with spinal fusion for SK in the hands of experienced spinal deformity surgeons.
Coe
Jeffrey D
JD
Silicon Valley Spine Institute, Campbell, CA 95008, USA. jcoe@svspine.com
Smith
Justin S
JS
Berven
Sigurd
S
Arlet
Vincent
V
Donaldson
William
W
Hanson
Darrell
D
Mudiyam
Ram
R
Perra
Joseph
J
Owen
Jeffrey
J
Marks
Michelle C
MC
Shaffrey
Christopher I
CI
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012544:Scheuermann Disease / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000209:etiology*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D014946:Wound Infection / Q000209:etiology*