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Research Article
Factors and Predictive Model Associated With Perioperative Complications After Long Fusion in the Treatment of Adult Non-Degenerative Scoliosis
Nan Wu
Peking Union Medical College Hospital
Corresponding Author
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Introduction
Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied.
Methods
We evaluated clinical and radiographical results from 180 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis.
Results
180 adult non-degenerative scoliosis patients were included in our study. There were 31 perioperative complications for 25 (13.9%) patients, 11 of which were cardiopulmonary-related complications, five of which were infection, six of which were neurological-related complications, three of which were gastrointestinal-related complications, and six of which were incision-related problems. The independent risk factors for development of perioperative complications included change in Cobb angle (odds ratio [OR]=1.058, 95% CI=1.011~1.108, P=0.015), change in central vertical axis (CVA) (OR=1.066, 95% CI=1.019-1.116, P=0.006) and red blood cell (RBC) transfusion (OR=5.631, 95% CI=1.676~18.924, P=0.005). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.746.
Conclusions
Blood transfusion, Cobb change, and CVA change were independent risk factors for perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients.
Keywords
Adult non-degenerative scoliosis, Perioperative complications, Risk factors, Long-segment posterior instrumentation, fusion
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Editorial decision: Major revision
On 01 Jan, 2021
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Received 21 Dec, 2020
Review #2 received
Received 21 Dec, 2020
Review #1 received
Received 21 Dec, 2020
Review #3 received
Received 21 Dec, 2020
Reviewer #3 agreed
On 19 Dec, 2020
Reviewer #7 agreed
On 19 Dec, 2020
Reviewer #5 agreed
On 19 Dec, 2020
Reviewer #4 agreed
On 19 Dec, 2020
Reviewer #2 agreed
On 19 Dec, 2020
Reviewer #1 agreed
On 19 Dec, 2020
Reviewer #6 agreed
On 19 Dec, 2020
Reviewers invited
Invitations sent on 16 Dec, 2020
Editor assigned
On 16 Dec, 2020
Editor invited
On 14 Dec, 2020
Submission checks complete
On 14 Dec, 2020
First submitted
On 03 Dec, 2020
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Subject Areas
Orthopedics
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This preprint is under consideration at BMC Musculoskeletal Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Factors and Predictive Model Associated With Perioperative Complications After Long Fusion in the Treatment of Adult Non-Degenerative Scoliosis
Nan Wu
Peking Union Medical College Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 16 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 01 Jan, 2021
Review #4 received
Received 21 Dec, 2020
Review #2 received
Received 21 Dec, 2020
Review #1 received
Received 21 Dec, 2020
Review #3 received
Received 21 Dec, 2020
Reviewer #3 agreed
On 19 Dec, 2020
Reviewer #7 agreed
On 19 Dec, 2020
Reviewer #5 agreed
On 19 Dec, 2020
Reviewer #4 agreed
On 19 Dec, 2020
Reviewer #2 agreed
On 19 Dec, 2020
Reviewer #1 agreed
On 19 Dec, 2020
Reviewer #6 agreed
On 19 Dec, 2020
Reviewers invited
Invitations sent on 16 Dec, 2020
Editor assigned
On 16 Dec, 2020
Editor invited
On 14 Dec, 2020
Submission checks complete
On 14 Dec, 2020
First submitted
On 03 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Orthopedics
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Introduction
Adult non-degenerative scoliosis accounts for 90% of spinal deformities in young adults. However, perioperative complications and related risk factors of long posterior instrumentation and fusion for the treatment of adult non-degenerative scoliosis have not been adequately studied.
Methods
We evaluated clinical and radiographical results from 180 patients with adult non-degenerative scoliosis who underwent long posterior instrumentation and fusion. Preoperative clinical data, intraoperative variables, and perioperative radiographic parameters were collected to analyze the risk factors for perioperative complications. Potential and independent risk factors for perioperative complications were evaluated by univariate analysis and logistic regression analysis.
Results
180 adult non-degenerative scoliosis patients were included in our study. There were 31 perioperative complications for 25 (13.9%) patients, 11 of which were cardiopulmonary-related complications, five of which were infection, six of which were neurological-related complications, three of which were gastrointestinal-related complications, and six of which were incision-related problems. The independent risk factors for development of perioperative complications included change in Cobb angle (odds ratio [OR]=1.058, 95% CI=1.011~1.108, P=0.015), change in central vertical axis (CVA) (OR=1.066, 95% CI=1.019-1.116, P=0.006) and red blood cell (RBC) transfusion (OR=5.631, 95% CI=1.676~18.924, P=0.005). The area under the receiver operating characteristic (ROC) curve based on predicted probability of the logistic regression was 0.746.
Conclusions
Blood transfusion, Cobb change, and CVA change were independent risk factors for perioperative complications after long-segment posterior instrumentation and fusion in adult non-degenerative scoliosis patients.
Figure 1
Figure 2