Complications associated with surgical treatment of traumatic spinal fractures: a review of the scoliosis research society morbidity and mortality database.

Authors

• Brian J Williams
• Justin S Smith
• Dwight Saulle
• Christopher P Ames
• Lawrence G Lenke
• Paul A Broadstone
• Alexander R Vaccaro
• David W Polly
• Christopher I Shaffrey

Publication/Presentation Date

1-1-2014

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.

Volume

81

Issue

5-6

First Page

818

Last Page

824

ISSN

1878-8769

Published In/Presented At

Williams, B. J., Smith, J. S., Saulle, D., Ames, C. P., Lenke, L. G., Broadstone, P. A., Vaccaro, A. R., Polly, D. W., Jr, & Shaffrey, C. I. (2014). Complications associated with surgical treatment of traumatic spinal fractures: a review of the scoliosis research society morbidity and mortality database. World neurosurgery, 81(5-6), 818–824. https://doi.org/10.1016/j.wneu.2013.02.013

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

23396067

Department(s)

Administration and Leadership

Document Type

Article