• Aladine A Elsamadicy, Owoicho Adogwa, Hunter Warwick, Amanda Sergesketter, Emily Lydon, Ronnie L Shammas, Ankit I Mehta, Raul A Vasquez, Joseph Cheng, Carlos A Bagley, and Isaac O Karikari.
• Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
• World Neurosurg. 2017 Jun 1; 102: 370-375.

ObjectiveRecent studies have reported that decompression with fusion leads to superior outcomes in correction of spinal deformity. The aim of this study was to determine if there is a difference in intraoperative and 30-day postoperative complication rates in patients undergoing spinal fusion with and without decompression.MethodsMedical records of 874 adult (≥18 years old) patients with spinal deformity undergoing elective spinal fusion at a major academic institution from 2005 to 2015 were reviewed; 374 (42.8%) patients underwent laminectomy in addition to spinal fusion. The primary outcome investigated was the rate of intraoperative and 30-day complications.ResultsPatient demographics and comorbidities were similar between groups. The laminectomy cohort had significantly higher estimated blood loss (P < 0.0001), incidence of allogeneic blood transfusions (P = 0.0001), and rate of intraoperative durotomies (laminectomy cohort 10.4% vs. no-laminectomy cohort 3.1%; P < 0.0001). The laminectomy cohort had a significantly higher proportion of patients in the intensive care unit (28.6% vs. 17.7%; P < 0.001). There was no significant difference in 30-day readmission rate between cohorts (laminectomy cohort 13.0% vs. no-laminectomy cohort 9.8%; P = 0.13). Within 30 days after initial discharge, the laminectomy cohort had significantly higher rates of altered mental status (3.2% vs. 1.2%; P = 0.05), urinary tract infection (4.3% vs. 1.4%; P = 0.009), wound drainage (7.2% vs. 3.1%; P = 0.007), and instrumentation failure (1.1% vs. 0.0%; P = 0.03).ConclusionsPatients undergoing spinal fusion with laminectomy may have higher complication rates than patients undergoing spinal fusion alone.Copyright © 2017 Elsevier Inc. All rights reserved.

25 keywords...

hide…