Risk factors for postoperative pulmonary complications in the treatment of non-degenerative scoliosis by posterior instrumentation and fusion
The aim of this study was to evaluate the prevalence and risk factors for postoperative pulmonary complications (PPC) after posterior instrumentation and fusion (PIF) in patients with non-degenerative scoliosis.
We retrospectively evaluated 703 patients (224 males, 479 females) diagnosed with non-degenerative scoliosis who underwent PIF in our center from January 2010 to January 2018. Preoperative, perioperative, demographic data, surgical methods and radiographic parameters were extracted and analyzed to identify risk factors for PPC.
The mean age of the patients was 20.8 ± 9.0 years with the following diagnoses: congenital scoliosis (287/703, 40.8%), idiopathic scoliosis (281/703, 40.0%), neuromuscular scoliosis (103/703, 14.7%) and syndromic scoliosis (32/703, 4.5%). PPC manifested in 82 patients (11.7%) including pleural effusion (39/82, 47.6%), pneumonia (33/82, 40.2%), pneumothorax (3/82, 3.7%), respiratory failure (3/82, 3.7%), hemothorax (2/82, 2.4%), pulmonary edema (1/82, 1.2%) and pulmonary embolism (1/82, 1.2%). Multifactorial regression analysis confirmed that revision surgery [odds ratio (OR) = 2.320, P = 0.030], preoperative respiratory disease (OR = 14.286, P < 0.001), preoperative Cobb angle of main curve > 75° (OR = 1.701, P = 0.046) and thoracoplasty (OR = 4.098 P < 0.001) were risk factors for PPC after PIF in patients with non-degenerative scoliosis.
A prevalence of 11.7% PPC was observed after PIF. Risk factors were preoperative Cobb angle of main curve > 75°, preoperative respiratory disease, revision surgery and thoracoplasty. Surgeons should recognize and pay attention to these risk factors and take appropriate preventive measures to prevent severe pulmonary complications.
KeywordsScoliosis Pulmonary complications Spine Fusion
The authors gratefully acknowledge the support from Beijing Chaoyang Hospital affiliated to China Capital Medical University. The author also thanks Dr. Yong Hai who supervised the study, provided technique support and corrected some mistakes.
This study has not received any fund support.
Compliance with ethical standards
Conflict of interest
All the authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
- 8.De la Garza Ramos R, Goodwin CR, Abu-Bonsrah N et al (2016) Patient and operative factors associated with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the nationwide Inpatient Sample. J Neurosurg Pediatr 25(6):730–736Google Scholar