Impact of Complications on the Quality of Life of Patients Who Underwent Surgery for Adult Spinal Deformity
DOI:
https://doi.org/10.47363/JSAR/2022(3)137Keywords:
Spinal Heformity, Spinal Surgery, Complications, Health Related Quality of life, Infections, Proximal Junctional Kyphosis, Adult Deformity, Revision Surgery, Mechanical Complication, Medical ComplicationsAbstract
Study Design: A multicenter, retrospective review of surgical patients with adult spine deformity.
Objective: Analyze the impact on the quality of life of patients who suffer complications in adult spine deformity surgery.
Summary of Background Data: Adult spine deformity surgery is classically associated with a high rate of complications, in particular it is estimate around 40%. The knowledge of the impact these complications could be a useful to improve the outcome
in quality of life of patients.
Methods: Retrospective analysis of a prospective database of a cohort of patients who underwent spinal deformity surgery. Patients with 4 or more instrumented vertebras and 2 years follow-up of were included. We created two groups based on the development or not of complications. VAS, ODI and SRS22, as a quality of life questionnaires, were used. Statistical analysis was performed using: T Student and U Mann-Whitney tests depending if variables were adjusted or not to normality; independent and related samples were analyzed with W Wilcoxon test.
Results: 65 patients from primary surgery completed all the protocols (75.4% female) , mean age of the cohort was 68 ± 6.21 years, the average number of levels fused was 7 ± 3.37, with an operative time of 305.47 ± 116.90 minutes with 406.50 ± 92.7 mL of estimated blood loss. 24 patients suffered complications including PJK, instrumentation rupture, malposition material and infection. The results of the quality of life of patients with complications showing a significant statistical improvement in all parameters except the function subdomain (Pre- Complication: 2.55 ± 0.66; Post-Complication 2.93 ± 0.85, p = 0.082) and satisfaction subdomain (Pre-Complication 3.25 ± 1.25; Post-Complication 3.84 ± 0.91, p = 0.095) of the SRS-22 regarding the preoperative. The disability, that the ODI shows, is better and statistically significant than the preoperative one although it remains at high levels (Pre-Complication 57.58 ± 16.01; Post-Complication 43.47 ± 17.1, p < 0.05). Considering the pain in the VAS back [(Pre-Complication 8 (5.50-9); Post Complication 4 (1.50-7.50), p < 0.05] and VAS leg [(Pre-Complication: 8 (5-8); Post 2 (0.50-5), p < 0.05] this significant improvement after complication. Quality of life parameters in patients with complications were affected, although with no statistically significant differences in comparison to the group of patients without re- surgery for some complication.
Conclusions: The impact on quality of life of subjects who suffer complications in comparison to those that do not is reflected in greater functional limitations and worse results in subdomains of the SRS-22 questionnaire, despite improving after the surgery and without significant differences in comparison to the group of patients free from complications.
