Complication rates of three common spine procedures and rates of thromboembolism following spine surgery based on 108,419 procedures: a report from the Scoliosis Research Society Morbidity and Mortality Committee.
METHODS
Retrospective review of a prospectively collected database.


OBJECTIVE
The Scoliosis Research Society (SRS) collects morbidity and mortality (M and M) data from its members. Our objectives were to assess complication rates for 3 common spine procedures, compare these results with prior literature as a means of validating the database, and to assess rates of pulmonary embolism (PE) and deep venous thrombosis (DVT) in all cases reported to the SRS over 4 years.


BACKGROUND
Few modern series document complication rates of spinal surgery as routinely practiced across academic and community settings. Those available are typically based on relatively low numbers of procedures or confined to single-surgeon experiences.


METHODS
The SRS M and M database was queried for lumbar microdiscectomy (LD), anterior cervical discectomy and fusion (ACDF), and lumbar stenosis decompression (LSD) cases from 2004 to 2007. Revisions were excluded. The database was also queried for occurrence of clinically evident PE and DVT in all cases from 2004 to 2007.


RESULTS
A total of 9692 LDs, 6735 ACDFs, and 10,329 LSDs were identified, with overall complication rates of 3.6%, 2.4%, and 7.0%, respectively. These rates are comparable to previously published smaller series. For assessment of PE and DVT, 108,419 cases were identified and rates were calculated per 1000 cases based on diagnosis, age group, and implant use. Overall rates of PE, death due to PE, and DVT were 1.38, 0.34, and 1.18, respectively. Among 82,082 adults, the rate of PE ranged from 0.47 for LD to 12.4 for metastatic tumor. Similar variations were noted for DVT and deaths due to PE.


CONCLUSIONS
Overall major complication rates for LD, ACDF, and LSD based on the SRS M and M database are comparable to those in previously reported smaller series, supporting the validity of this database for study of other less common spinal disorders. In addition, our data provide general benchmarks of clinically evident PE and DVT rates as a basis for ongoing efforts to improve care.
Smith
Justin S
JS
Department of Neurosurgery, University of Virginia Medical Center, Charlottesville, VA 22908, USA.
Fu
Kai-Ming G
KM
Polly
David W
DW
Sansur
Charles A
CA
Berven
Sigurd H
SH
Broadstone
Paul A
PA
Choma
Theodore J
TJ
Goytan
Michael J
MJ
Noordeen
Hilali H
HH
Knapp
Dennis Raymond
DR
Hart
Robert A
RA
Donaldson
William F
WF
Perra
Joseph H
JH
Boachie-Adjei
Oheneba
O
Shaffrey
Christopher I
CI
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D019992:Databases as Topic; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000401:mortality; D017586:Diskectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007223:Infant; D008159:Lumbar Vertebrae / Q000601:surgery*; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012600:Scoliosis / Q000601:surgery*; D012955:Societies, Medical; D013123:Spinal Fusion / Q000009:adverse effects* / Q000401:mortality; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000209:etiology* / Q000401:mortality; D055815:Young Adult