Medical Student USF Health Morsani College of Medicine
Disclosure(s):
Chloe Chose, BS: No financial relationships to disclose
Introduction: Surgery for adult spinal deformity (ASD) can effectively reduce pain and morbidity, yet carries significant risks of complications (8-42%) and subsequent revision surgery (9-18%). Previous studies have reported conflicting complication rates between primary and revision surgeries, necessitating further investigation. We compare complication profiles between primary and revision ASD surgeries.
Methods: We conducted a retrospective review of all ASD surgeries at our tertiary care center from 2016 to 2023 (n=265). Inclusion criteria were age >18 and fusion of ≥5 vertebrae. Data on surgical and postoperative complications were collected. Complications were compared between primary surgeries (n=149) and revision surgeries (n=116) using chi-squared tests in SPSS, with significance set at p ≤ 0.05.
Results: Comparison of primary and revision surgery cohorts revealed no significant differences in rates of proximal junctional kyphosis, wound infection/breakdown, pleural effusion/hemothorax, deep vein thrombosis, pulmonary embolism, blood transfusion, pneumonia, urinary tract infection, sepsis, and pneumothorax. Rhabdomyolysis was significantly less common in revision surgeries (12.2%) compared to primary surgeries (21.6%) (p=0.045). Overall non-surgical complications (p=0.320) and surgical complications (p=0.408) did not significantly differ between cohorts.
Conclusion : Revision surgery for ASD did not exhibit higher overall complication rates compared to primary surgery. Notably, revision surgeries showed a lower incidence of rhabdomyolysis, potentially due to reduced muscle dissection requirements. These findings suggest similar complication profiles between primary and revision ASD surgeries, aiding surgeons in patient counseling and decision-making regarding surgical correction of iatrogenic flatback syndrome and sequelae of previous surgeries.