A Comprehensive Review of Complication Rates After Surgery for Adult Deformity: A Reference for Informed Consent.


Journal Article

OBJECTIVE: An up-to-date review of recent literatures and a comprehensive reference for informed consent specific to ASD complications is lacking. The goal of the present study was to determine current complication rates after ASD surgery, in order to provide a reference for informed consent as well as to determine differences between three-column and non-three-column osteotomy procedures to aid in shared decision making. METHODS: A review of the literature was conducted using the PubMed database. Randomized controlled trials, nonrandomized trials, cohort studies, case-control studies, and case series providing postoperative complications published in 2000 or later were included. Complication rates were recorded and calculated for perioperative (both major and minor) and long-term complication rates. Postoperative outcomes were all stratified by surgical procedure (ie, three-column osteotomy and non-three-column osteotomy). RESULTS: Ninety-three articles were ultimately eligible for analysis. The data of 11,692 patients were extracted; there were 3,646 complications, mean age at surgery was 53.3 years (range: 25-77 years), mean follow-up was 3.49 years (range: 6 weeks-9.7 years), estimated blood loss was 2,161 mL (range: 717-7,034 mL), and the overall mean complication rate was 55%. Specifically, major perioperative complications occurred at a mean rate of 18.5%, minor perioperative complications occurred at a mean rate of 15.7%, and long-term complications occurred at a mean rate of 20.5%. Furthermore, three-column osteotomy resulted in a higher overall complication rate and estimated blood loss than non-three-column osteotomy. CONCLUSIONS: A review of recent literatures providing complication rates for ASD surgery was performed, providing the most up-to-date incidence of early and late complications. Providers may use such data in helping to counsel patients of the literature-supported complication rates of such procedures despite the planned benefits, thus obtaining a more thorough informed consent.

Full Text

Duke Authors

Cited Authors

  • Sciubba, DM; Yurter, A; Smith, JS; Kelly, MP; Scheer, JK; Goodwin, CR; Lafage, V; Hart, RA; Bess, S; Kebaish, K; Schwab, F; Shaffrey, CI; Ames, CP; International Spine Study Group (ISSG),

Published Date

  • November 2015

Published In

Volume / Issue

  • 3 / 6

Start / End Page

  • 575 - 594

PubMed ID

  • 27927561

Pubmed Central ID

  • 27927561

Electronic International Standard Serial Number (EISSN)

  • 2212-1358

Digital Object Identifier (DOI)

  • 10.1016/j.jspd.2015.04.005


  • eng

Conference Location

  • England