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Spinal osteotomy in patients with ankylosing spondylitis: complications during first postoperative year
Karel F Willems1, Gerard H Slot, Patricia G Anderson
1Institute for Spine Surgery and Applied Research, Sint Maartenskliniek, Nijmegen, The Netherlands.
Study Design:
A historic cohort to determine short-term complications after 115 corrective osteotomies of the cervical and lumbar spine in patients with ankylosing spondylitis.
Objectives:
To describe the nature of complications of spinal osteotomies and sequelae.
Summary Of Background Data:
Little is known about the rate and nature of complications after spinal osteotomy in these patients.
Methods:
A chart review of 106 patients (age, 21-82 years) was conducted. The following surgical techniques were performed: cervical-thoracic extending osteotomy at C6-Th1 (n = 22), lumbar closing-wedge osteotomy (n = 62), polysegmental lumbar osteotomy (n = 20), or a combined anterior-posterior lumbar correction (n = 11).
Results:
Many complications (7.8% permanent neurologic deficit, 9.6% deep wound infections, and 10.4% major general complications) occurred after performing a spinal correction. Since 1998, there is a tendency for a lower rate of infections but a higher rate of neurologic and major general complications. Because of 27% deep wound infections and 18% major general complications, the technique of combined anterior and posterior surgery has been abandoned.
Conclusion:
High complication rates in this group of patients are partly due to the difficult surgery but also to the underlying disease. The surgery should be concentrated in specialized centers.
