A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity

Committee for Adult Deformity, Japanese Scoliosis Society

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society. Methods This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society. Patients who underwent corrective fusion surgery for ASD between 2011 and 2013 were included. Demographics, comorbidities, surgical data, and complications were investigated. Results A total of 1192 patients (mean age, 57.7 years) were included in this study. Of these, 611 patients were aged less than 65 years and 581 patients were aged 65 years or greater. The age distribution had two peaks, in the third and eighth decades. Deformities caused by degeneration represented 67% of the pathology in patients aged over 65 years; however, non-degenerative disease such as adult idiopathic scoliosis and syndromic or congenital deformity represented over 60% of pathology in patients aged less than 65 years. The iatrogenic deformity and reoperation rates were both less than 3%. The mean operation time and estimated blood loss were 370 min and 1642 ml, respectively. Major perioperative complications occurred in 160 patients (14.5%). The incidence of complications was significantly higher in patients aged over 65 years, including neurological deficits, hemorrhagic shock, hematoma, heart failure, and surgical site infection (p < 0.05). Conclusions Older (aged over 65 years) ASD patients showed greater rates of deformity due to the occurrence of degeneration and vertebral fractures, as well as a higher incidence of peri-and postoperative complications. Efforts to reduce perioperative complications are therefore imperative, especially for elderly ASD patients in our aging society.

Original languageEnglish
Pages (from-to)237-242
Number of pages6
JournalJournal of Orthopaedic Science
Volume22
Issue number2
DOIs
Publication statusPublished - 2017 Mar 1

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Scoliosis
Surveys and Questionnaires
Japan
Pathology
Surgical Wound Infection
Hemorrhagic Shock
Incidence
Age Distribution
Reoperation
Hematoma
Comorbidity
Spine
Heart Failure
Demography

ASJC Scopus subject areas

  • Medicine(all)
  • Orthopedics and Sports Medicine

Cite this

A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity. / Committee for Adult Deformity, Japanese Scoliosis Society.

In: Journal of Orthopaedic Science, Vol. 22, No. 2, 01.03.2017, p. 237-242.

Research output: Contribution to journalArticle

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title = "A Japanese nationwide multicenter survey on perioperative complications of corrective fusion for elderly patients with adult spinal deformity",
abstract = "Background Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society. Methods This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society. Patients who underwent corrective fusion surgery for ASD between 2011 and 2013 were included. Demographics, comorbidities, surgical data, and complications were investigated. Results A total of 1192 patients (mean age, 57.7 years) were included in this study. Of these, 611 patients were aged less than 65 years and 581 patients were aged 65 years or greater. The age distribution had two peaks, in the third and eighth decades. Deformities caused by degeneration represented 67{\%} of the pathology in patients aged over 65 years; however, non-degenerative disease such as adult idiopathic scoliosis and syndromic or congenital deformity represented over 60{\%} of pathology in patients aged less than 65 years. The iatrogenic deformity and reoperation rates were both less than 3{\%}. The mean operation time and estimated blood loss were 370 min and 1642 ml, respectively. Major perioperative complications occurred in 160 patients (14.5{\%}). The incidence of complications was significantly higher in patients aged over 65 years, including neurological deficits, hemorrhagic shock, hematoma, heart failure, and surgical site infection (p < 0.05). Conclusions Older (aged over 65 years) ASD patients showed greater rates of deformity due to the occurrence of degeneration and vertebral fractures, as well as a higher incidence of peri-and postoperative complications. Efforts to reduce perioperative complications are therefore imperative, especially for elderly ASD patients in our aging society.",
author = "{Committee for Adult Deformity, Japanese Scoliosis Society} and Yu Yamato and Yukihiro Matsuyama and Kazuhiro Hasegawa and Yoichi Aota and Tsutomu Akazawa and Takahiro Iida and Kazumasa Ueyama and Koki Uno and Tokumi Kanemura and Noriaki Kawakami and Toshiaki Kotani and Masashi Takaso and Jun Takahashi and Masato Tanaka and Hiroshi Taneichi and Taichi Tsuji and Hideo Hosoe and Joji Mochida and Takachika Shimizu and Ikuho Yonezawa and Koota Watanabe and Morio Matsumoto",
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AU - Committee for Adult Deformity, Japanese Scoliosis Society

AU - Yamato, Yu

AU - Matsuyama, Yukihiro

AU - Hasegawa, Kazuhiro

AU - Aota, Yoichi

AU - Akazawa, Tsutomu

AU - Iida, Takahiro

AU - Ueyama, Kazumasa

AU - Uno, Koki

AU - Kanemura, Tokumi

AU - Kawakami, Noriaki

AU - Kotani, Toshiaki

AU - Takaso, Masashi

AU - Takahashi, Jun

AU - Tanaka, Masato

AU - Taneichi, Hiroshi

AU - Tsuji, Taichi

AU - Hosoe, Hideo

AU - Mochida, Joji

AU - Shimizu, Takachika

AU - Yonezawa, Ikuho

AU - Watanabe, Koota

AU - Matsumoto, Morio

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society. Methods This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society. Patients who underwent corrective fusion surgery for ASD between 2011 and 2013 were included. Demographics, comorbidities, surgical data, and complications were investigated. Results A total of 1192 patients (mean age, 57.7 years) were included in this study. Of these, 611 patients were aged less than 65 years and 581 patients were aged 65 years or greater. The age distribution had two peaks, in the third and eighth decades. Deformities caused by degeneration represented 67% of the pathology in patients aged over 65 years; however, non-degenerative disease such as adult idiopathic scoliosis and syndromic or congenital deformity represented over 60% of pathology in patients aged less than 65 years. The iatrogenic deformity and reoperation rates were both less than 3%. The mean operation time and estimated blood loss were 370 min and 1642 ml, respectively. Major perioperative complications occurred in 160 patients (14.5%). The incidence of complications was significantly higher in patients aged over 65 years, including neurological deficits, hemorrhagic shock, hematoma, heart failure, and surgical site infection (p < 0.05). Conclusions Older (aged over 65 years) ASD patients showed greater rates of deformity due to the occurrence of degeneration and vertebral fractures, as well as a higher incidence of peri-and postoperative complications. Efforts to reduce perioperative complications are therefore imperative, especially for elderly ASD patients in our aging society.

AB - Background Recently, corrective fusion surgery for patients with adult spinal deformity (ASD) has become common in Japan. This study aimed to clarify the status of surgeries for ASD in Japan, focusing on perioperative complications. A nationwide multicenter survey gathering information on surgically treated ASD patients was conducted by the committee for Adult Spinal Deformity of the Japanese Scoliosis Society. Methods This study was a review of retrospectively collected data from 18 spine scoliosis centers belonging to the Japanese Scoliosis Society. Patients who underwent corrective fusion surgery for ASD between 2011 and 2013 were included. Demographics, comorbidities, surgical data, and complications were investigated. Results A total of 1192 patients (mean age, 57.7 years) were included in this study. Of these, 611 patients were aged less than 65 years and 581 patients were aged 65 years or greater. The age distribution had two peaks, in the third and eighth decades. Deformities caused by degeneration represented 67% of the pathology in patients aged over 65 years; however, non-degenerative disease such as adult idiopathic scoliosis and syndromic or congenital deformity represented over 60% of pathology in patients aged less than 65 years. The iatrogenic deformity and reoperation rates were both less than 3%. The mean operation time and estimated blood loss were 370 min and 1642 ml, respectively. Major perioperative complications occurred in 160 patients (14.5%). The incidence of complications was significantly higher in patients aged over 65 years, including neurological deficits, hemorrhagic shock, hematoma, heart failure, and surgical site infection (p < 0.05). Conclusions Older (aged over 65 years) ASD patients showed greater rates of deformity due to the occurrence of degeneration and vertebral fractures, as well as a higher incidence of peri-and postoperative complications. Efforts to reduce perioperative complications are therefore imperative, especially for elderly ASD patients in our aging society.

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JF - Journal of Orthopaedic Science

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