Plastic Surgery Involvement in Index Posterior Spine Surgery Reduces Complication Rates

Plastic surgery is typically involved in the reconstruction of complex wounds of the back resulting from complications of posterior spine surgery. This study examined the temporal relationship of plastic surgery involvement in posterior spine surgery and the effect on postoperative complications.

A national insurance-based database was utilized for data collection. Patients who underwent first-instance posterior spine surgery between 2010 and 2019 were included. Ninety-day wound complications, reoperation rates, ED visits, and hospital admissions were compared when plastic surgery closure was done on the same day as index spine surgery and subsequently at different time periods within 1 year. Multivariate logistic regression analysis was utilized to uncover variables that predict plastic surgery consultation.

A total of 320,072 posterior spine surgery patients did not have plastic surgery involvement, whereas 1213 patients had plastic surgery intervention either on the same day or within 1 year of the index procedure. Same-day plastic surgery involvement had significantly lower rates of 90-day wound complications compared with within 1 month (25.2% vs. 70.8%, P <0.001). ED visits, hospital admissions, and reoperations were also significantly lower in patients with same-day plastic surgery closure compared with those within 1 month. The odds of plastic surgery consultation were greater with spinal fracture, history of prior spine revision, 3 to 6 vertebral segment fixation, ≥13 vertebral segment fixation, sacral fracture, male sex, and increasing Charlson Comorbidity Index (CCI).

Patients undergoing posterior spine surgery may benefit from same-day plastic surgery closure, decreasing the rate of wound complications, hospital admissions, and reoperations.