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Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity.

Publication ,  Journal Article
Smith, JS; Shaffrey, CI; Kim, HJ; Passias, P; Protopsaltis, T; Lafage, R; Mundis, GM; Klineberg, E; Lafage, V; Schwab, FJ; Scheer, JK; Hart, R ...
Published in: Neurosurgery
December 1, 2018

BACKGROUND: Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates. OBJECTIVE: To assess all-cause mortality following ACSD surgery. METHODS: ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed. RESULTS: Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60.6 yr). The mean number of comorbidities per patient was 1.80, and 80% had at least 1 comorbidity. Surgical approaches included anterior only (15.8%), posterior only (50.0%), and combined anterior/posterior (34.2%). The mean number of vertebral levels fused was 8.0 (standard deviation [SD] = 4.5), and 23.3% had a 3-column osteotomy. Death was reported for 11 (9.2%) patients at a mean of 1.1 yr (SD = 0.76 yr; range = 7 d to 2 yr). Mean follow-up for living patients was 1.2 yr (SD = 0.64 yr). Causes of death included myocardial infarction (n = 2), pneumonia/cardiopulmonary failure (n = 2), sepsis (n = 1), obstructive sleep apnea/narcotics (n = 1), subsequently diagnosed amyotrophic lateral sclerosis (n = 1), burn injury related to home supplemental oxygen (n = 1), and unknown (n = 3). Deceased patients did not significantly differ from alive patients based on demographic, clinical, or surgical parameters assessed, except for a higher major complication rate (excluding mortality; 63.6% vs 22.0%, P = .006). CONCLUSION: All-cause mortality at a mean of 1.2 yr following surgery for ACSD was 9.2% in this prospective multicenter series. Causes of death were reflective of the overall high level of comorbidities. These findings may prove useful for treatment decision making and patient counseling in the context of the substantial impact of ACSD.

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Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

December 1, 2018

Volume

83

Issue

6

Start / End Page

1277 / 1285

Location

United States

Related Subject Headings

  • Spinal Curvatures
  • Prospective Studies
  • Osteotomy
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female
  • Comorbidity
  • Cervical Vertebrae
 

Citation

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Chicago
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Smith, J. S., Shaffrey, C. I., Kim, H. J., Passias, P., Protopsaltis, T., Lafage, R., … International Spine Study Group, . (2018). Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity. Neurosurgery, 83(6), 1277–1285. https://doi.org/10.1093/neuros/nyx605
Smith, Justin S., Christopher I. Shaffrey, Han Jo Kim, Peter Passias, Themistocles Protopsaltis, Renaud Lafage, Gregory M. Mundis, et al. “Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity.Neurosurgery 83, no. 6 (December 1, 2018): 1277–85. https://doi.org/10.1093/neuros/nyx605.
Smith JS, Shaffrey CI, Kim HJ, Passias P, Protopsaltis T, Lafage R, et al. Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity. Neurosurgery. 2018 Dec 1;83(6):1277–85.
Smith, Justin S., et al. “Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity.Neurosurgery, vol. 83, no. 6, Dec. 2018, pp. 1277–85. Pubmed, doi:10.1093/neuros/nyx605.
Smith JS, Shaffrey CI, Kim HJ, Passias P, Protopsaltis T, Lafage R, Mundis GM, Klineberg E, Lafage V, Schwab FJ, Scheer JK, Miller E, Kelly M, Hamilton DK, Gupta M, Deviren V, Hostin R, Albert T, Riew KD, Hart R, Burton D, Bess S, Ames CP, International Spine Study Group. Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity. Neurosurgery. 2018 Dec 1;83(6):1277–1285.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

December 1, 2018

Volume

83

Issue

6

Start / End Page

1277 / 1285

Location

United States

Related Subject Headings

  • Spinal Curvatures
  • Prospective Studies
  • Osteotomy
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Female
  • Comorbidity
  • Cervical Vertebrae