Format

Send to

Choose Destination
Neurosurgery. 2018 Dec 1;83(6):1277-1285. doi: 10.1093/neuros/nyx605.

Prospective Multicenter Assessment of All-Cause Mortality Following Surgery for Adult Cervical Deformity.

Author information

1
Department of Neurosurgery, University of Virginia, Charlottesville, Virginia.
2
Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
3
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York.
4
Scripps Clinic, San Diego, California.
5
Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California.
6
Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois.
7
Stanford Physical Medicine and Rehabilitation, Redwood City, California.
8
Department of Orthopedic Surgery, Washington University, St Louis, Missouri.
9
Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
10
Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, California.
11
Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, Texas.
12
Department of Orthopaedic Surgery, Columbia University, New York City, New York.
13
Department of Orthopaedic Surgery, Swedish Medical Center, Seattle, Washington.
14
Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas.
15
Presbyterian St Lukes Medical Center, Denver, Colorado.
16
Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.

Abstract

BACKGROUND:

Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates.

OBJECTIVE:

To assess all-cause mortality following ACSD surgery.

METHODS:

ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed.

RESULTS:

Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60.6 yr). The mean number of comorbidities per patient was 1.80, and 80% had at least 1 comorbidity. Surgical approaches included anterior only (15.8%), posterior only (50.0%), and combined anterior/posterior (34.2%). The mean number of vertebral levels fused was 8.0 (standard deviation [SD] = 4.5), and 23.3% had a 3-column osteotomy. Death was reported for 11 (9.2%) patients at a mean of 1.1 yr (SD = 0.76 yr; range = 7 d to 2 yr). Mean follow-up for living patients was 1.2 yr (SD = 0.64 yr). Causes of death included myocardial infarction (n = 2), pneumonia/cardiopulmonary failure (n = 2), sepsis (n = 1), obstructive sleep apnea/narcotics (n = 1), subsequently diagnosed amyotrophic lateral sclerosis (n = 1), burn injury related to home supplemental oxygen (n = 1), and unknown (n = 3). Deceased patients did not significantly differ from alive patients based on demographic, clinical, or surgical parameters assessed, except for a higher major complication rate (excluding mortality; 63.6% vs 22.0%, P = .006).

CONCLUSION:

All-cause mortality at a mean of 1.2 yr following surgery for ACSD was 9.2% in this prospective multicenter series. Causes of death were reflective of the overall high level of comorbidities. These findings may prove useful for treatment decision making and patient counseling in the context of the substantial impact of ACSD.

PMID:
29351637
DOI:
10.1093/neuros/nyx605

Supplemental Content

Full text links

Icon for Silverchair Information Systems
Loading ...
Support Center