title: Complications associated with surgical treatment of traumatic spinal fractures: a review of the scoliosis research society morbidity and mortality database.
abstract: OBJECTIVE
  Traumatic spinal fracture is a common indication for surgery, with an associated high incidence of perioperative complications. The literature provides a wide range in the incidence of complications. We seek to assess the perioperative morbidity and mortality of surgery for traumatic spinal fractures and to identify predictors of their occurrence.
  
  
  METHODS
  We performed a retrospective analysis of all traumatic spinal fracture cases submitted by members of the Scoliosis Research Society from 2004 to 2007.
  
  
  RESULTS
  A total of 108,478 cases were submitted from 2004 through 2007, with 6,706 (6.2%) performed for treatment of traumatic fracture. Twenty-two percent of patients had preoperative neurological deficits. Intraoperative neuromonitoring was used in 58% of cases. The overall incidence of complications was 6.9%. The perioperative mortality was 0.5%. There were 59 (0.9%) new postoperative neurological deficits. Multivariate analysis demonstrated preoperative neurological deficit (P = .001; odds ratio [OR] 1.449, 95% confidence interval [CI] [1.156 to 1.817]) and fusion (P =.001; OR 1.12, 95% CI [1.072 to 1.168]) as predictors of complications and use of intraoperative neuromonitoring (P = .016; OR 1.949, 95% CI [1.13 to 3.361]), and preoperative neurological deficit (P < .001; OR 2.964, 95% CI [1.667 to 5.271]) as predictors of new postoperative neurological deficits (P < .001).
  
  
  CONCLUSIONS
  Overall, surgery for the treatment of spinal fractures was performed with relatively low incidences of perioperative complications (6.9%) and mortality (0.5%). These data may prove useful for patient counseling and ongoing efforts to improve the safety of operative care for patients with spinal fracture.
authors: University of Virginia Medical Center, Department of Neurosurgery, Charlottesville, Virginia, USA.
authors: Brian J
authors: BJ
authors: Williams
authors: University of Virginia Medical Center, Department of Neurosurgery, Charlottesville, Virginia, USA. Electronic address: jss7f@virgina.edu.
authors: Justin S
authors: JS
authors: Smith
authors: University of Virginia Medical Center, Department of Neurosurgery, Charlottesville, Virginia, USA.
authors: Dwight
authors: D
authors: Saulle
authors: University of California-San Francisco, Department of Neurosurgery, San Francisco, California, USA.
authors: Christopher P
authors: CP
authors: Ames
authors: Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri, USA.
authors: Lawrence G
authors: LG
authors: Lenke
authors: Spine Surgery Associates, Chattanooga, Tennessee, USA.
authors: Paul A
authors: PA
authors: Broadstone
authors: Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
authors: Alexander R
authors: AR
authors: Vaccaro
authors: Departments of Orthopedic Surgery and Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA.
authors: David W
authors: DW
authors: Polly
authors: University of Virginia Medical Center, Department of Neurosurgery, Charlottesville, Virginia, USA.
authors: Christopher I
authors: CI
authors: Shaffrey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D009017:Morbidity; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012600:Scoliosis / Q000401:mortality; D016103:Spinal Fractures / Q000401:mortality* / Q000601:surgery*; D013124:Spinal Injuries / Q000401:mortality* / Q000601:surgery*; D055815:Young Adult
keywords: Complication; Fracture; Mortality; Spine surgery; Spine trauma