• Shaishav Bhagat, V Vozar, L Lutchman, R J Crawford, and A S Rai.
• Department of Orthopaedic Surgery, Norfolk and Norwich University Hospital, Colney lane, Norwich, Norfolk, NR4 7UY, UK. Shaishav.bhagat@yahoo.co.uk
• Eur Spine J. 2013 Mar 1;22 Suppl 1:S42-6.

PurposeThis study analyses the complications of spinal deformity surgery in adults to highlight pre-disposing factors.MethodsThe clinical records and imaging were reviewed for 48 consecutive patients, 12 males and 36 females, with a mean age of 64 (31-86), who had surgery for spinal deformity. Mean follow-up time was 36 months (24-60). Patient data recorded were age, diagnosis and co-morbidities; deformity assessment: curve type, sagittal and coronal balance, Cobb angle. Operation details: number of instrumented levels, duration and intra-operative complications.Outcomecomplications, re-operations, balance and Cobb angle.Results28 patients (58 %) had at least 1, 15 patients (27 %) had 2 and 5 patients (9.5 %) had more than 2 co-morbidities. Average time between 1st presentation and operation was 13 months (1-41). The mean number of levels fused was 10.8 (4-23). In addition to posterior pedicle screw instrumentation, 40 patients had chevron osteotomies and 8 had pedicle substraction osteotomies. Posterior interbody fusions were performed at one level in 17 of which 7 had 2 level fusion. Two patients had combined anterior and posterior approaches. Fusion to the pelvis was performed in 19 patients. There were a total of 27 major and minor complications in 19/48 (39.5 %) patients. Late complications included 5 patients who had revisions for proximal junctional kyphosis, 1 patient had revision for pseudoarthrosis and 4 patients had removal of mal-positioned screws.ConclusionsFactors associated with high complication rate in adult spinal deformity surgery are age, co-morbidities and severe sagittal imbalance at the time of presentation.

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