Complications of surgical treatment of idiopathic scoliosis in adolescents

Abstract

Introduction. In modern literature, there are still debates on causes of the most common complications after surgeries for idiopathic scoliosis in adolescents and their risk factors. Currently, there are growing potentials to reduce the length of patients’ postoperative stay in hospitals, but it arises the need for attending physicians to know better the main types of complications of juvenile idiopathic scoliosis after surgery, their risk factors so as to predict and avoid them, to develop an individual program for patient’s management in the postoperative period, especially for patients from the risk group.Material and methods. Literature search was done in databases Pubmed, Medline, Google Scholar, using key words, on complications of surgical correction of juvenile idiopathic scoliosis.Results. On analyzing the obtained literature data, two large groups of postoperative complications were described in details: somatic and neurological. In addition to most common complications, some rare ones are described too which include superior mesenteric artery syndrome and distant deep infections.Conclusion. Over the past twenty years, the incidence of postoperative complications after surgical correction of scoliotic deformities has significantly decreased. When analyzing findings of various trials, it can be concluded that the overall complication rate decreased in 2004-2007 from 5.7% (2000-2003) to 4.95% and then to 0.98% (2013-2016). Despite the general decrease in the incidence of complications, the latter still remain a problem for clinicians. The basic risk factors for such complications are: concomitant renal pathology, large volume of surgical blood loss, significant increase of exposure to anesthesia and surgical intervention, application of stainless steel constructions, anterior or combined surgical access, refusal of intraoperative neuromonitoring.