• Parth Kothari, Sulaiman Somani, Nathan J Lee, Javier Z Guzman, Dante M Leven, Branko Skovrlj, Jeremy Steinberger, Jun Kim, and Samuel K Cho.
• Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States.
• Global Spine J. 2017 Feb 1; 7 (1): 39-46.

Study DesignRetrospective study of prospectively collected data.ObjectiveTo determine if patients undergoing spinal deformity surgery with pelvic fixation are at an increased risk of morbidity.MethodsThe American College of Surgeons National Surgical Quality Improvement Program is a large multicenter clinical registry that prospectively collects preoperative risk factors, intraoperative variables, and 30-day postoperative morbidity and mortality outcomes from ~400 hospitals nationwide. Current Procedural Terminology codes were used to query the database between 2010 and 2014 for adults who underwent fusion for spinal deformity. Patients were separated into groups of those with and without pelvic fixation. Univariate analysis and multivariate logistic regression were used to analyze the effect of pelvic fixation on the incidence of postoperative morbidity and other surgical outcomes.ResultsMultivariate analysis showed that pelvic fixation was a significant predictor of overall morbidity (odds ratio [OR] = 2.3, 95% confidence interval [CI]: 1.7 to 3.1, p = 0.0002), intra- or postoperative blood transfusion (OR = 2.3, 95% CI: 1.7 to 3.1 p < 0.0001), extended operative time (OR = 4.7, 95% CI: 3.1 to 7.0 p < 0.0001), and length of stay > 5 days (OR = 2.1, 95% CI 1.5 to 2.8, p < 0.0001) in patients undergoing fusion for spinal deformity. However, fusion to the pelvis did not lead to additional risk for other complications, including wound complications (p = 0.3191).ConclusionAdult patients undergoing spinal deformity surgery with pelvic fixation were not susceptible to increased morbidity beyond increased blood loss, greater operative time, and extended length of stay.

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