Mechanical complications in adult deformity surgery: behavioral patterns

Area of Science:

• Spine surgery
• Orthopedic surgery
• Deformity correction

Background:

• Mechanical complications are often grouped in adult deformity surgery.
• Differentiating these complications by onset and predisposing factors is needed.

Purpose of the Study:

• To characterize mechanical complications after adult deformity surgery.
• To analyze onset patterns and predisposing factors for specific complications.

Main Methods:

• Retrospective analysis of a prospective multicenter database.
• Kaplan-Meier survival analysis and Cox regression models were used.
• Identified factors included clinical, biological, radiographic, and surgical parameters.

Main Results:

• 17.3% of 1,505 patients developed mechanical complications.
• Proximal junctional problems (PJK/PJF) and fusion failure (PA/RB) showed distinct time-to-event patterns.
• Age, instrumented levels, and sagittal alignment were associated with proximal junctional problems; fusion failure was linked to instrumented levels, BMI, and mid-term alignment.

Conclusions:

• Proximal junctional problems and fusion failure exhibit different onset times and associated factors.
• Immediate postoperative sagittal alignment influences proximal junctional problems.
• Mid-term biological factors and sagittal alignment impact fusion failure.