Grading of Complications After Cervical Deformity-corrective Surgery: Are Existing Classification Systems Applicable?

Area of Science:

• Spine surgery
• Surgical complications
• Patient outcomes

Background:

• The Clavien-Dindo classification system is validated for general surgery but its applicability in cervical deformity (CD) populations is unclear.
• Postoperative complications significantly impact patient outcomes in CD surgery.

Purpose of the Study:

• To assess the impact of complication type and Clavien complication (Cc) grade on clinical outcomes in surgical CD patients.
• To determine the utility of the Clavien-Dindo system in CD patients.

Main Methods:

• Retrospective review of a prospective multicenter CD database.
• Included 153 adult surgical CD patients with baseline and postoperative data.
• Analyzed complication types and Cc grades against outcomes like estimated blood loss (EBL), length of stay (LOS), reoperation, and health-related quality of life (HRQL).

Main Results:

• 63% of patients experienced at least one complication.
• Operative complications were linked to increased EBL; several other types increased LOS.
• Increasing complication severity (Cc grade) correlated with higher reoperation risk but not with inferior 1-year HRQL outcomes.

Conclusions:

• The Clavien-Dindo classification system's severity grading did not correlate with EBL, LOS, or 1-year HRQL in CD patients.
• The system may require modification for improved applicability and utility in CD-specific populations.
• Operative complications were the only type associated with increased EBL.