Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children

Objective. To analyze the structure and frequency of complications after surgical treatment of non-traumatic spinal disorders in children and to identify factors affecting the development of the disorders. Material and Methods. The study included follow-up data of 218 children who underwent no le...

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Main Authors: Denis G. Naumov, Aleksandr Yu. Mushkin
Format: Article
Language:English
Published: Ministry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan" 2017-09-01
Series:Хирургия позвоночника
Subjects:
Online Access:https://www.spinesurgery.ru/jour/article/view/433/1335
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author Denis G. Naumov
Aleksandr Yu. Mushkin
author_facet Denis G. Naumov
Aleksandr Yu. Mushkin
author_sort Denis G. Naumov
collection DOAJ
description Objective. To analyze the structure and frequency of complications after surgical treatment of non-traumatic spinal disorders in children and to identify factors affecting the development of the disorders. Material and Methods. The study included follow-up data of 218 children who underwent no less than 2-level reconstructions of the spine for in- fectious and neoplastic destruction, as well as for congenital malformations of the spine in 2005–2015. The average period of long-term follow-up was 5 years 4 months. Sixteen patients developed complications requiring repeated surgical treatment in the long-term period (at least 12 months). Clinical and X-ray factors that influenced the risk of developing long-term complications were studied. Results. Four groups of complications were identified: recurrence (progression) of primary pathology (n = 5), pseudoarthrosis in the interface between bone graft and recipient vertebra (n = 6), proximal junctional kyphosis (n = 4), and bone graft resorption (n = 1). The influence of tho- racic lesions on the risk of pathology recurrence (p = 0.039) and of lumbar spine surgery on earlier complication development (p = 0.016) and pseudoarthrosis formation (p = 0.047), as well as on earlier appearance of secondary deformities as compared to other complications (p = 0.035) was statistically proved. The predictor value of such factors as etiology, age, gender and material used for anterior fusion (bone alone or titanium mesh with bone autograft) was not confirmed. Conclusion. The frequency of late complications after 360° vertebral reconstruction in children is 7.3 %, with most of them developing several years after surgery. Increase in surgical activity, number of operated patients and length of follow-up will possibly prove the presence of new pre- dictors of complication development.
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spelling doaj.art-f27cece26e0b484eba7d40c7d727e4462023-08-02T00:36:08ZengMinistry of Health of Russian Federation, Federal State Budgetary Institution "Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L. Tsivyan"Хирургия позвоночника1810-89972313-14972017-09-01143849210.14531/ss2017.3.84-92Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in childrenDenis G. Naumov0Aleksandr Yu. Mushkin1St. Petersburg Research Institute of Phthisiopulmonology, St. Petersburg, RussiaSt. Petersburg Research Institute of Phthisiopulmonology; Mechnikov North-West State Medical University, St. Petersburg, RussiaObjective. To analyze the structure and frequency of complications after surgical treatment of non-traumatic spinal disorders in children and to identify factors affecting the development of the disorders. Material and Methods. The study included follow-up data of 218 children who underwent no less than 2-level reconstructions of the spine for in- fectious and neoplastic destruction, as well as for congenital malformations of the spine in 2005–2015. The average period of long-term follow-up was 5 years 4 months. Sixteen patients developed complications requiring repeated surgical treatment in the long-term period (at least 12 months). Clinical and X-ray factors that influenced the risk of developing long-term complications were studied. Results. Four groups of complications were identified: recurrence (progression) of primary pathology (n = 5), pseudoarthrosis in the interface between bone graft and recipient vertebra (n = 6), proximal junctional kyphosis (n = 4), and bone graft resorption (n = 1). The influence of tho- racic lesions on the risk of pathology recurrence (p = 0.039) and of lumbar spine surgery on earlier complication development (p = 0.016) and pseudoarthrosis formation (p = 0.047), as well as on earlier appearance of secondary deformities as compared to other complications (p = 0.035) was statistically proved. The predictor value of such factors as etiology, age, gender and material used for anterior fusion (bone alone or titanium mesh with bone autograft) was not confirmed. Conclusion. The frequency of late complications after 360° vertebral reconstruction in children is 7.3 %, with most of them developing several years after surgery. Increase in surgical activity, number of operated patients and length of follow-up will possibly prove the presence of new pre- dictors of complication development.https://www.spinesurgery.ru/jour/article/view/433/1335childrenspinal pathologyspondylitisspinal tumorsspine reconstructionspine surgery
spellingShingle Denis G. Naumov
Aleksandr Yu. Mushkin
Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
Хирургия позвоночника
children
spinal pathology
spondylitis
spinal tumors
spine reconstruction
spine surgery
title Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
title_full Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
title_fullStr Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
title_full_unstemmed Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
title_short Analysis of risk factors of late complications after spine reconstruction surgery for non-traumatic pathology in children
title_sort analysis of risk factors of late complications after spine reconstruction surgery for non traumatic pathology in children
topic children
spinal pathology
spondylitis
spinal tumors
spine reconstruction
spine surgery
url https://www.spinesurgery.ru/jour/article/view/433/1335
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