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Complications in the Adult Spinal Deformity Patient Having Combined Surgery: Does Revision Increase the Risk?

Linville, Douglas A., MD; Bridwell, Keith H., MD; Lenke, Lawrence G., MD; Vedantam, Ravishankar, MD; Leicht, Patricia, RN


Study Design. A comparison of short-term complications (within 6 months after surgery) between primary combined adult spinal deformity (multilevel scoliosis, kyphosis, fixed coronal-sagittal imbalance) surgeries (n = 18) and combined adult spinal deformity revision surgeries (n = 26).

Objectives. To analyze the short-term complications and to determine whether revision status increases the risks of short-term complications in this group of patients.

Summary of Background Data. There is no peer-reviewed article comparing complications of revision to those in primary patients in a group of patients undergoing combined surgery for adult spinal deformity.

Methods. Major and minor complications were analyzed for both patient groups, and demographic data were collected. The demographic data of the two groups were very similar.

Results. The major (11.1% vs. 7.8%) and minor (11.1% vs. 11.5%) complications for the two groups (primary vs. revision) were very similar. All patients had combined procedures and all were patients with adult spinal deformity. The wound complications were less in those receiving total parenteral nutrition (2 of 31) than in those without (2 of 13). The group receiving parenteral nutrition was thought to be at higher risk for wound complications.

Conclusions. The risk of major and minor complications within the first 6 months after surgery is not necessarily greater in the revision group than in the primary group of patients with adult spinal deformity who have combined surgeries. Total parenteral nutrition does appear to have a role in many of these patients.

From the Washington University School of Medicine Department of Orthopaedic Surgery, Spinal Deformity Service, St. Louis, Missouri.

Acknowledgment date: January 23, 1998.

First revision date: March 26, 1998.

Acceptance date: May 12, 1998.

Device status category: 7.

Address reprint requests to: Keith H. Bridwell, MD; Department of Orthopaedic Surgery; Spinal Deformity Service; Washington University School of Medicine; One Barnes-Jewish Hospital Plaza; Suite 11300 West Pavilion; St. Louis, MO 63110; E-mail:

© 1999 Lippincott Williams & Wilkins, Inc.