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Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study.

Publication ,  Journal Article
Elsamadicy, AA; Adogwa, O; Warwick, H; Sergesketter, A; Lydon, E; Shammas, RL; Mehta, AI; Vasquez, RA; Cheng, J; Bagley, CA; Karikari, IO
Published in: World neurosurgery
June 2017

Recent studies have reported that decompression with fusion leads to superior outcomes in correction of spinal deformity. The aim of this study was to determine if there is a difference in intraoperative and 30-day postoperative complication rates in patients undergoing spinal fusion with and without decompression.Medical records of 874 adult (≥18 years old) patients with spinal deformity undergoing elective spinal fusion at a major academic institution from 2005 to 2015 were reviewed; 374 (42.8%) patients underwent laminectomy in addition to spinal fusion. The primary outcome investigated was the rate of intraoperative and 30-day complications.Patient demographics and comorbidities were similar between groups. The laminectomy cohort had significantly higher estimated blood loss (P < 0.0001), incidence of allogeneic blood transfusions (P = 0.0001), and rate of intraoperative durotomies (laminectomy cohort 10.4% vs. no-laminectomy cohort 3.1%; P < 0.0001). The laminectomy cohort had a significantly higher proportion of patients in the intensive care unit (28.6% vs. 17.7%; P < 0.001). There was no significant difference in 30-day readmission rate between cohorts (laminectomy cohort 13.0% vs. no-laminectomy cohort 9.8%; P = 0.13). Within 30 days after initial discharge, the laminectomy cohort had significantly higher rates of altered mental status (3.2% vs. 1.2%; P = 0.05), urinary tract infection (4.3% vs. 1.4%; P = 0.009), wound drainage (7.2% vs. 3.1%; P = 0.007), and instrumentation failure (1.1% vs. 0.0%; P = 0.03).Patients undergoing spinal fusion with laminectomy may have higher complication rates than patients undergoing spinal fusion alone.

Duke Scholars

Published In

World neurosurgery

DOI

EISSN

1878-8769

ISSN

1878-8750

Publication Date

June 2017

Volume

102

Start / End Page

370 / 375

Related Subject Headings

  • Spinal Cord Diseases
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laminectomy
  • Humans
  • Female
  • Evoked Potentials, Somatosensory
  • Electroencephalography
 

Citation

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Elsamadicy, A. A., Adogwa, O., Warwick, H., Sergesketter, A., Lydon, E., Shammas, R. L., … Karikari, I. O. (2017). Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study. World Neurosurgery, 102, 370–375. https://doi.org/10.1016/j.wneu.2017.03.096
Elsamadicy, Aladine A., Owoicho Adogwa, Hunter Warwick, Amanda Sergesketter, Emily Lydon, Ronnie L. Shammas, Ankit I. Mehta, et al. “Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study.World Neurosurgery 102 (June 2017): 370–75. https://doi.org/10.1016/j.wneu.2017.03.096.
Elsamadicy AA, Adogwa O, Warwick H, Sergesketter A, Lydon E, Shammas RL, et al. Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study. World neurosurgery. 2017 Jun;102:370–5.
Elsamadicy, Aladine A., et al. “Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study.World Neurosurgery, vol. 102, June 2017, pp. 370–75. Epmc, doi:10.1016/j.wneu.2017.03.096.
Elsamadicy AA, Adogwa O, Warwick H, Sergesketter A, Lydon E, Shammas RL, Mehta AI, Vasquez RA, Cheng J, Bagley CA, Karikari IO. Increased 30-Day Complication Rates Associated with Laminectomy in 874 Adult Patients with Spinal Deformity Undergoing Elective Spinal Fusion: A Single Institutional Study. World neurosurgery. 2017 Jun;102:370–375.
Journal cover image

Published In

World neurosurgery

DOI

EISSN

1878-8769

ISSN

1878-8750

Publication Date

June 2017

Volume

102

Start / End Page

370 / 375

Related Subject Headings

  • Spinal Cord Diseases
  • Retrospective Studies
  • Postoperative Complications
  • Middle Aged
  • Male
  • Laminectomy
  • Humans
  • Female
  • Evoked Potentials, Somatosensory
  • Electroencephalography