Several spine surgeons and researchers received The Kostuik Innovation Award from the International Society for the Advancement of Spine Surgery for their work on variability of three-column osteotomies for spinal deformity.
The recognition was presented at the 2014 ISASS Annual Meeting last month. Here are five things to know about the award-winning study titled "Complications and Inter-center Variability of Three Column Osteotomies for Spinal Deformity Surgery: A Retrospective of 423 Patients" and its authors:
1. The authors examined three-column resection osteotomies, which are commonly performed for sagittal deformity but have a high complication rate. The researchers examined 423 consecutive patients at eight surgical centers and found:
• 7 percent had major intraoperative complications
• 39 percent had postoperative complications up to six weeks post-surgery
• 42 percent overall complication rate
The most common IOC was spinal cord deficit and the most common POC was an unplanned return to the operating room.
2. Patients with two osteotomies were more likely to have POCs and those with thoracic osteotomies had more IOCs, POCs and overall complications. Major blood loss instance was 24 percent for the study population, with significant variation for each site. Patients with major blood loss also had a higher risk of IOC, POC and overall complication. The average percentage of total blood lost was 55 percent, varying among sites.
3. The researchers concluded that given the complexity of three-column osteotomies for spinal deformity, "it is important for spine surgeons to understand the risk factors and complication rates associated with these procedures." A separate 2013 study published in Spine examines three-column osteotomies for spinal deformity patients 60 years and older. The study includes 51 patients, with 18 percent experiencing major complications; another 39 percent experienced minor complications.
4. A 2012 study examining major complications for three-column osteotomy techniques found the rates were similar for pedicle subtraction osteotomy and vertebral column resection. Among the 105 procedures studied, 24.8 percent of the patients had major surgical complications and 15.2 percent had major medical complications. However, the authors concluded the presence of major complications did not affect the ultimate clinical outcomes at two years or more.
5. The article was authored by Kristina Bianco, BA, Robert Norton, MD, Frank Schwab, MD, Justin Smith, MD, PhD, Eric Klinenberg, MD, Ibrahim Obeid, MD, Gregory Mundis Jr., MD, Christopher I. Shaffrey, MD, Khaled Kebaish, MD, Richard Hostin, MD, Robert Hart, MD, Munish C. Gupta, MD, Douglas Burton, MD, Christopher Ames, MD, Oheneba Boachie-Adjei, MD, Themistocles S. Protopsaltis, MD, and Virginie Lafarge, PhD. The study was conducted on behalf of the International Spine Study Group.
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