• Justin S Smith, Subaraman Ramchandran, Virginie Lafage, Christopher I Shaffrey, Tamir Ailon, Eric Klineberg, Themistocles Protopsaltis, Frank J Schwab, Michael OʼBrien, Richard Hostin, Munish Gupta, Gregory Mundis, Robert Hart, Han Jo Kim, Peter G Passias, Justin K Scheer, Vedat Deviren, Douglas C Burton, Robert Eastlack, Shay Bess, Todd J Albert, K Daniel Riew, Christopher P Ames, and International Spine Study Group.
• *Department of Neurosurgery, University of Virginia, Charlottesville, Virginia; ‡Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York; §Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California; ¶Department of Orthopaedic Surgery, Baylor Scoliosis Center, Plano, Texas; ‖San Diego Center for Spinal Disorders, La Jolla, California; #Department of Orthopaedic Surgery, Oregon Health & Science University, Portland, Oregon; **Department of Orthopaedic Surgery, Hospital for Special Surgery, New York City, New York; ‡‡University of California San Diego, School of Medicine, San Diego, California; §§Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, California; ¶¶Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas; ‖‖Rocky Mountain Hospital for Children, Denver, Colorado; ##Department of Orthopedic Surgery, Columbia University, New York; ***Department of Neurological Surgery, University of California, San Francisco, San Francisco, California.
• Neurosurgery. 2016 Sep 1; 79 (3): 378-88.

BackgroundFew reports have focused on treatment of adult cervical deformity (ACD).ObjectiveTo present early complication rates associated with ACD surgery.MethodsA prospective multicenter database of consecutive operative ACD patients was reviewed for early (≤30 days from surgery) complications. Enrollment required at least 1 of the following: cervical kyphosis >10 degrees, cervical scoliosis >10 degrees, C2-7 sagittal vertical axis >4 cm, or chin-brow vertical angle >25 degrees.ResultsSeventy-eight patients underwent surgical treatment for ACD (mean age, 60.8 years). Surgical approaches included anterior-only (14%), posterior-only (49%), anterior-posterior (35%), and posterior-anterior-posterior (3%). Mean numbers of fused anterior and posterior vertebral levels were 4.7 and 9.4, respectively. A total of 52 early complications were reported, including 26 minor and 26 major. Twenty-two (28.2%) patients had at least 1 minor complication, and 19 (24.4%) had at least 1 major complication. Overall, 34 (43.6%) patients had at least 1 complication. The most common complications included dysphagia (11.5%), deep wound infection (6.4%), new C5 motor deficit (6.4%), and respiratory failure (5.1%). One (1.3%) mortality occurred. Early complication rates differed significantly by surgical approach: anterior-only (27.3%), posterior-only (68.4%), and anterior-posterior/posterior-anterior-posterior (79.3%) (P = .007).ConclusionThis report provides benchmark rates for overall and specific ACD surgery complications. Although the surgical approach(es) used were likely driven by the type and complexity of deformity, there were significantly higher complication rates associated with combined and posterior-only approaches compared with anterior-only approaches. These findings may prove useful in treatment planning, patient counseling, and ongoing efforts to improve safety of care.Abbreviations3CO, 3-column osteotomiesACD, adult cervical deformityEBL, estimated blood lossISSG, International Spine Study groupSVA, sagittal vertical axis.

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