Complications of the treatment of post-traumatic deformities of the thoracic and lumbar spine using staged surgical interventions
https://doi.org/10.14531/ss2020.1.6-14
Abstract
Objective. To analyze the results of surgical treatment of post-traumatic deformities of the thoracic and lumbar spine using staged surgical interventions from the point of view of surgical safety, and to study the structure, frequency and nature of intra- and postoperative complications and intraoperative blood loss.
Material and Methods. A retrospective analysis of data of 212 patients for 2015–2018 was performed. Inclusion criteria were: age over 18 years, staged surgical interventions including anterior spinal fusion and posterior internal fixation performed in one surgical session for post-traumatic deformities of the thoracic and lumbar spine. Patient demographic data and surgical intervention protocols were studied taking into account surgical approaches, duration of operations and blood loss. Intraoperative and postoperative complications up to 6 weeks after surgery were taken into account. Intraoperative blood loss was studied both as the absolute volume and as the percentage of circulating blood volume (CBV).
Results. Complications after staged surgical correction of post-traumatic deformities were recorded in 14.2 % of patients, including intraoperative complications in 3.3 % of cases, and postoperative complications in 10.9 %. The most common complications were surgical site infections, usually after posterior approach, and pneumonia. The number of neurological complications was 1.4 %. Complications were more frequent after three-stage surgical interventions than after two-stage ones. The lumbar spine deformity correction was associated with higher complication rate than that in the thoracic spine. Intraoperative blood loss in the study group was 562.2 ± 504.7 ml. The most significant blood loss, over 30 % of the СBV, was noted in 13 (6.1 %) patients. Using of minimally invasive transpedicular fixation during the staged surgical intervention provided the least number of infectious wound complications and the smallest amount of intraoperative blood loss.
Conclusion. Staged surgical intervention for the correction of post-traumatic deformity of the thoracic and lumbar spine is a safe method of surgical treatment.
Material and Methods. A retrospective analysis of data of 212 patients for 2015–2018 was performed. Inclusion criteria were: age over 18 years, staged surgical interventions including anterior spinal fusion and posterior internal fixation performed in one surgical session for post-traumatic deformities of the thoracic and lumbar spine. Patient demographic data and surgical intervention protocols were studied taking into account surgical approaches, duration of operations and blood loss. Intraoperative and postoperative complications up to 6 weeks after surgery were taken into account. Intraoperative blood loss was studied both as the absolute volume and as the percentage of circulating blood volume (CBV).
Results. Complications after staged surgical correction of post-traumatic deformities were recorded in 14.2 % of patients, including intraoperative complications in 3.3 % of cases, and postoperative complications in 10.9 %. The most common complications were surgical site infections, usually after posterior approach, and pneumonia. The number of neurological complications was 1.4 %. Complications were more frequent after three-stage surgical interventions than after two-stage ones. The lumbar spine deformity correction was associated with higher complication rate than that in the thoracic spine. Intraoperative blood loss in the study group was 562.2 ± 504.7 ml. The most significant blood loss, over 30 % of the СBV, was noted in 13 (6.1 %) patients. Using of minimally invasive transpedicular fixation during the staged surgical intervention provided the least number of infectious wound complications and the smallest amount of intraoperative blood loss.
Conclusion. Staged surgical intervention for the correction of post-traumatic deformity of the thoracic and lumbar spine is a safe method of surgical treatment.
About the Authors
K. O. Borzykh
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
Konstantin Olegovich Borzykh, MD, PhD, senior reseacher of the Spine Surgery Department
17 Frunze str., Novosibirsk, 630091, Russia
V. V. Rerikh
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan;
Novosibirsk State Medical University
Russian Federation
Russian Federation
Victor Viktorovich Rerikh, DMSc, Head of the Spine Surgery Department; Professor of traumatology and orthopedics
17 Frunze str., Novosibirsk, 630091, Russia
52 Krasny pr., Novosibirsk, 630091, Russia
V. V. Borin
Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan
Russian Federation
Russian Federation
Vladislav Vasilyevich Borin, physitian of the Department of anesthesiology and reanimation
17 Frunze str., Novosibirsk, 630091, Russia
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Review
For citations:
Borzykh K.O., Rerikh V.V., Borin V.V. Complications of the treatment of post-traumatic deformities of the thoracic and lumbar spine using staged surgical interventions. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2020;17(1):6-14. https://doi.org/10.14531/ss2020.1.6-14
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