PREVALENCE OF PERIOPERATIVE COMPLICATIONS AFTER ANTERIOR SPINAL-FUSION FOR PATIENTS WITH IDIOPATHIC SCOLIOSIS

Anterior spinal fusion (ASF) has been proven to improve curve correcti on, save motion segments, and decrease the rate of pseudarthrosis when compared with posterior spinal fusion alone. However, in patients wit h idiopathic scoliosis, the complication rate of the anterior approach to the spine using current techniques has only been scantly defined i n the literature. This is a retrospective review of consecutive patien ts who underwent primary ASF for idiopathic scoliosis to determine the prevalence and types of complications specifically related to the ant erior approach. All patients who underwent primary ASFs for idiopathic scoliosis done by one of two orthopaedic surgeons between October 198 6 and July 1992 were reviewed. Adequate records were available for 98 of 103 patients. The average age at time of surgery was 22 years (rang e, 10-60 years). Complications were divided into three groups: major ( resulting in permanent sequelae or necessitating a second major operat ion); minor (resulting in a prolonged hospital stay, necessitating a m inor operation, and/or resulting in a significant temporary hardship o r persistent minor problem); and insignificant (anything less than min or). One of 98 patients had a major complication (a pelvic deep venous thrombosis that required operative thrombectomy). Twenty-five of 98 p atients had 28 complications classified as minor, and 28 of 98 patient s had 30 complications classified as insignificant. Smoking was a sign ificant risk factor for the development of minor complications. There was no statistically significant relationship between the development of complications and the degree of curve, the approach used, the proce dure performed, or the performance of rib resections. The anterior app roach to the spine in patients with idiopathic scoliosis in this serie s was very safe, with only one major complication in 98 patients. Howe ver, minor and insignificant complications were quite common, occurrin g in 45 of 98 patients (46%). Smoking was a significant risk factor fo r minor complications.