Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P23. Trends in complications in operative adolescent and adult idiopathic scoliosis from the SRS morbidity and mortality database

Abstract

BACKGROUND CONTEXT Surgical techniques in adolescent idiopathic scoliosis (AIS, age=10–18 years) and adult idiopathic scoliosis (ADS, age>18 years) surgery have evolved over the past 10years. PURPOSE To assess trends in complication rates in AIS and ADS patients from the Scoliosis Research Society (SRS) Morbidity and Mortality (MM n=63,574) and ADS (18–30 years; n=27,990) surgeries from one file. A second file contained the demographics, surgical data and types of complications data (2004–2015) of patients who had only complications. There were 1,165 AIS and 139 ADS patients with complications. Neurological deficit, blindness and death rates over 7years (2009–2015), and infection rates over 4years (2012–2015) were analyzed for both populations. In patients with complications data, we analyzed blood loss, number of levels fused, neurological recovery rate, and type of surgeries. Linear regression was used to analyze the trends of changes. P RESULTS In AIS patients (p=.02), the amount of blood loss was significantly reduced from 957 mL to 750 mL (2009–2015), and in ADS patients, blood loss was also significantly reduced (p=.02) from 1438 mL to 904 mL (2009–2015). The number of levels fused in the AIS patients (p=.02) significantly increased from 11 levels to 11.9 levels (2009–2015), and also in ADS patients (p=.04) from 10.4 levels to 12.7 levels (2009–2015). In AIS (p=.052) and ADS (p=.03) fusion levels increased significantly over 7years for Lenke type 1 curves. In the AIS population, posterior fusion rate (p=.002) significantly increased and anterior fusion rate (p=.001) significantly decreased over the 12-year analysis (2004–2015). In the ADS population, posterior fusion rate (p=.002) increased, and combined surgeries (p=.046) and anterior fusion rates (p=.035) decrease over the 12-year analysis. In the AIS population, death, blindness and neurological deficits rates were constant over the 7-year analysis (2009–2015), spinal infections rate was constant over 4years of analysis (2012–2015), neurological deficits recovery rate significantly decreased (p=.05). In ADS population, death rate was constant, blindness (p=.04) and neurological deficit (p=.04) rates significantly increased over the 7years of analysis (2009–2015), and spinal infections rate was constant from 2012–2015. CONCLUSIONS Over 12years, the amount of blood loss and anterior surgery rates significantly decreased in both populations. Posterior fusion rates and number of fused levels significantly increased in both populations. Neurological deficit and blindness rates were constant in AIS patients, but significantly increased in the ADS patients. Complications rates in ADS patients increased even with the evolution of surgical techniques compared to AIS population.