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Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis.

Publication ,  Journal Article
Sansur, CA; Reames, DL; Smith, JS; Hamilton, DK; Berven, SH; Broadstone, PA; Choma, TJ; Goytan, MJ; Noordeen, HH; Knapp, DR; Hart, RA ...
Published in: J Neurosurg Spine
November 2010

OBJECT: This is a retrospective review of 10,242 adults with degenerative spondylolisthesis (DS) and isthmic spondylolisthesis (IS) from the morbidity and mortality (M&M) index of the Scoliosis Research Society (SRS). This database was reviewed to assess complication incidence, and to identify factors that were associated with increased complication rates. METHODS: The SRS M&M database was queried to identify cases of DS and IS treated between 2004 and 2007. Complications were identified and analyzed based on age, surgical approach, spondylolisthesis type/grade, and history of previous surgery. Age was stratified into 2 categories: > 65 years and ≤ 65 years. Surgical approach was stratified into the following categories: decompression without fusion, anterior, anterior/posterior, posterior without instrumentation, posterior with instrumentation, and interbody fusion. Spondylolisthesis grades were divided into low-grade (Meyerding I and II) versus high-grade (Meyerding III, IV, and V) groups. Both univariate and multivariate analyses were performed. RESULTS: In the 10,242 cases of DS and IS reported, there were 945 complications (9.2%) in 813 patients (7.9%). The most common complications were dural tears, wound infections, implant complications, and neurological complications (range 0.7%-2.1%). The mortality rate was 0.1%. Diagnosis of DS had a significantly higher complication rate (8.5%) when compared with IS (6.6%; p = 0.002). High-grade spondylolisthesis correlated strongly with a higher complication rate (22.9% vs 8.3%, p < 0.0001). Age > 65 years was associated with a significantly higher complication rate (p = 0.02). History of previous surgery and surgical approach were not significantly associated with higher complication rates. On multivariate analysis, only the grade of spondylolisthesis (low vs high) was in the final best-fit model of factors associated with the occurrence of complications (p < 0.0001). CONCLUSIONS: The rate of total complications for treatment of DS and IS in this series was 9.2%. The total percentage of patients with complications was 7.9%. On univariate analysis, the complication rate was significantly higher in patients with high-grade spondylolisthesis, a diagnosis of DS, and in older patients. Surgical approach and history of previous surgery were not significantly correlated with increased complication rates. On multivariate analysis, only the grade of spondylolisthesis was significantly associated with the occurrence of complications.

Duke Scholars

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

November 2010

Volume

13

Issue

5

Start / End Page

589 / 593

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Spondylolisthesis
  • Spinal Fusion
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Neurosurgical Procedures
  • Multivariate Analysis
 

Citation

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Sansur, C. A., Reames, D. L., Smith, J. S., Hamilton, D. K., Berven, S. H., Broadstone, P. A., … Shaffrey, C. I. (2010). Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis. J Neurosurg Spine, 13(5), 589–593. https://doi.org/10.3171/2010.5.SPINE09529
Sansur, Charles A., Davis L. Reames, Justin S. Smith, D Kojo Hamilton, Sigurd H. Berven, Paul A. Broadstone, Theodore J. Choma, et al. “Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis.J Neurosurg Spine 13, no. 5 (November 2010): 589–93. https://doi.org/10.3171/2010.5.SPINE09529.
Sansur CA, Reames DL, Smith JS, Hamilton DK, Berven SH, Broadstone PA, et al. Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis. J Neurosurg Spine. 2010 Nov;13(5):589–93.
Sansur, Charles A., et al. “Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis.J Neurosurg Spine, vol. 13, no. 5, Nov. 2010, pp. 589–93. Pubmed, doi:10.3171/2010.5.SPINE09529.
Sansur CA, Reames DL, Smith JS, Hamilton DK, Berven SH, Broadstone PA, Choma TJ, Goytan MJ, Noordeen HH, Knapp DR, Hart RA, Zeller RD, Donaldson WF, Polly DW, Perra JH, Boachie-Adjei O, Shaffrey CI. Morbidity and mortality in the surgical treatment of 10,242 adults with spondylolisthesis. J Neurosurg Spine. 2010 Nov;13(5):589–593.

Published In

J Neurosurg Spine

DOI

EISSN

1547-5646

Publication Date

November 2010

Volume

13

Issue

5

Start / End Page

589 / 593

Location

United States

Related Subject Headings

  • Surgical Wound Infection
  • Spondylolisthesis
  • Spinal Fusion
  • Severity of Illness Index
  • Risk Factors
  • Retrospective Studies
  • Postoperative Complications
  • Orthopedics
  • Neurosurgical Procedures
  • Multivariate Analysis