Type of Approach Affects Complication Rates in Adult Deformity Surgery

The type of approach used during adult cervical deformity surgery may have a direct impact on the complication rates and severity of complications for patients, according to results of a study presented at the EuroSpine Annual Meeting in Copenhagen, Denmark.

In a study presented by Christopher P. Ames, M.D., patients who underwent cervical deformity surgery with an anterior-only approach had comparatively less early complications within 30 days of surgery and less major complication than patients who had other approaches. Ames is director of spinal tumor and spinal deformity surgery at the University of California-San Francisco (UCSF) Medical Center and co-director of the Neurospinal Disorders Program and the UCSF Spine Center.

“Significantly higher rates of complications were associated with posterior-only and with combined approach procedures compared with anterior-only procedures,” he said.

The multicenter study included 78 adult patients who had cervical deformity surgery. Overall, 57.7 percent of patients developed at least one complication and 25.4 percent developed a major complication, the data show. Dysphagia was the most common complication in the study, which accounted for 11.5 percent of the overall complications. About 9 percent of the dysphagia complications were minor and 2.6 percent were major, Ames said.

An anterior-only approach led to 27.3 percent of its patients developing a complication, compared with 68.4 percent of posterior approach patients and 79.3 percent of combination approach patients.

Ames noted that 14 percent of patients had an anterior-only approach, 49 percent of patients underwent a posterior-only approach, 35 percent of patients had an anterior-posterior approach and 3 percent of patients underwent a posterior-anterior-posterior approach.