title: Complication rate in adult deformity surgical treatment: safety of the posterior osteotomies.
abstract: OBJECTIVE
  The treatment of adult scoliosis is a challenge especially in patients over 50 years old with severe, rigid curves in whom the use of vertebral osteotomies may be necessary to correct the deformity. The aim the study was to analyse the perioperative complications related to vertebral osteotomies in elderly treated for spinal deformity.
  
  
  METHODS
  We analysed 72 consecutive cases of kyphoscoliosis, we classify them according to Berjano-Lamartina classification. We divided patients into two groups: we only practised SPO and/or PO in patients that composed group A; we practised also PSO in patients that composed group B. We retrospectively analysed the perioperative complications and radiographical results. Average follow-up was 30 months.
  
  
  RESULTS
  We had 50 cases of degenerative segment diseases (DSD) Type III, 13 Type IVa DSD and 9 Type IVb DSD. Mean age was 60.7 years old. Overall complication rate was 22.2 %. In group A, the complication rate was 16.9 % while in group B it was 46.2 %. Mean Cobb primary curve angle was 41.75° with average C7 plumb line (C7PL) of 4.49 cm, residual scoliosis after surgery was 15.41° and average C7PL of 2.08 cm, with statistically significant differences.
  
  
  CONCLUSIONS
  Previous studies have shown increased complication rates with vertebral osteotomies in elderly patients, our experience support this evidence. Our study demonstrates a high incidence of intraoperative complication rate in elderly patients underwent a PSO. PSO is a demanding technique to be considered in very selected and motivated patients who must be carefully informed about the risks of the procedure.
authors.affiliation: Spine Surgery Department, Orthopaedic Institute "Gaetano Pini", Piazza Cardinale Andrea Ferrari, 1, 20122, Milan, Italy.
authors.forename: Giovanni Andrea
authors.initials: GA
authors.lastname: La Maida
authors.affiliation: Spine Surgery Department, Orthopaedic Institute "Gaetano Pini", Piazza Cardinale Andrea Ferrari, 1, 20122, Milan, Italy. f.luceri88@gmail.com.|University of Milan, Milan, Italy. f.luceri88@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Luceri
authors.affiliation: University of Milan, Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Gallozzi
authors.affiliation: Spine Surgery Department, Orthopaedic Institute "Gaetano Pini", Piazza Cardinale Andrea Ferrari, 1, 20122, Milan, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ferraro
authors.affiliation: Spine Surgery Department, Orthopaedic Institute "Gaetano Pini", Piazza Cardinale Andrea Ferrari, 1, 20122, Milan, Italy.
authors.forename: Misaggi
authors.initials: M
authors.lastname: Bernardo
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology*; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Adult spinal deformity; Complication in spinal surgery; Pedicle subtraction osteotomy; Vertebral osteotomy