Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P111. Significant differences in morbidity when comparing adverse events for cervical and lumbar spine surgery prospectively graded with SAVES

Abstract

BACKGROUND CONTEXT Most studies on complications in spinal surgery have been retrospective, and the reporting of adverse events (AEs) has been inconsistent, regarding definitions and severity grading. Furthermore, to our knowledge no studies have reported on prospectively registered AEs comparing cervical with lumbar surgery at a single major spine surgical centre.The SpineAdVerse Events Severity (SAVES) system is a validated standardization of the prospective registration and classification of spine surgery AEs. PURPOSE To describe and compare the incidence of AEs, using the SAVES system, in patients undergoing lumbar surgery with patients undergoing cervical surgery for degenerative spinal diseases at one major tertiary spine centre. STUDY DESIGN/SETTING A prospective, consecutive cohort study. PATIENT SAMPLE All patients undergoing cervical or lumbar spine surgery during the inclusion period at one major tertiary surgical centre for degenerative spinal diseases. A signed agreement was obtained from all included patients. OUTCOME MEASURES Outcome measures were (a) all AEs registered according to the SAVES system, (b) length of stay (LOS), (c) readmission rate at 30 at 90days, (d) unplanned second surgery during index admission and (e) wound infections requiring revision. The primary outcome measure, comparing lumbar with cervical surgery, was the number of adverse events. METHODS All patients undergoing spinal surgery at our academic tertiary surgical centre were consecutively included from 010216 to 311017. Using the SAVES grading system an independent research coordinator, not involved in the treatment of the patients, prospectively collected all intra- and perioperative data. Once a week all patient charts were reviewed with a senior surgeon for validation of the data. The patients were grouped according to cervical or lumbar surgery. The Student t -test was used for comparing mean LOS, the Mann-Whitney U test for comparing AEs and Pearson chi-square test for comparisons of incidence between groups. RESULTS A total of 1,692 consecutive cases were included with 100% data completion, of which 1400 underwent lumbar, 287 underwent cervical, and 5 were excluded due to thoracic spine surgery. A total of 1,398 lumbar AEs (402 intra- and 996 perioperative) and 232 cervical AEs (84 intra- and 148 perioperative) were registered, resulting in a mean of 1.00 AEs per lumbar patient and 0.81 AEs per cervical patient (p CONCLUSIONS The results show significant fewer AEs and significant shorter length of stay in hospital when undergoing cervical compared to lumbar spine surgery. However, the data also show that the incidence of unplanned secondary surgery was significantly higher in the cervical group.