Risk factors for postoperative pulmonary complications in the treatment of non-degenerative scoliosis by posterior instrumentation and fusion

European spine journal

article

Yunsheng Wang¹  Yong Hai¹  Yuzeng Liu¹  Li Guan¹  Tie Liu¹ 

[1] Department of Orthopedic Surgery, Beijing Chao-Yang Hospital, Capital Medical University

关键词: Scoliosis;    Pulmonary complications;    Spine;    Fusion;   

DOI  :  10.1007/s00586-019-05968-5

来源: Springer

【 摘 要 】

The aim of this study was to evaluate the prevalence and risk factors for postoperative pulmonary complications (PPC) after posterior instrumentation and fusion (PIF) in patients with non-degenerative scoliosis. We retrospectively evaluated 703 patients (224 males, 479 females) diagnosed with non-degenerative scoliosis who underwent PIF in our center from January 2010 to January 2018. Preoperative, perioperative, demographic data, surgical methods and radiographic parameters were extracted and analyzed to identify risk factors for PPC. The mean age of the patients was 20.8 ± 9.0 years with the following diagnoses: congenital scoliosis (287/703, 40.8%), idiopathic scoliosis (281/703, 40.0%), neuromuscular scoliosis (103/703, 14.7%) and syndromic scoliosis (32/703, 4.5%). PPC manifested in 82 patients (11.7%) including pleural effusion (39/82, 47.6%), pneumonia (33/82, 40.2%), pneumothorax (3/82, 3.7%), respiratory failure (3/82, 3.7%), hemothorax (2/82, 2.4%), pulmonary edema (1/82, 1.2%) and pulmonary embolism (1/82, 1.2%). Multifactorial regression analysis confirmed that revision surgery [odds ratio (OR) = 2.320, P = 0.030], preoperative respiratory disease (OR = 14.286, P  75° (OR = 1.701, P = 0.046) and thoracoplasty (OR = 4.098 P  75°, preoperative respiratory disease, revision surgery and thoracoplasty. Surgeons should recognize and pay attention to these risk factors and take appropriate preventive measures to prevent severe pulmonary complications. These slides can be retrieved under Electronic Supplementary Material.

【 授权许可】

Unknown