Article Abstract

Inpatient morbidity after spinal deformity surgery in patients with movement disorders

Authors: Rafael De la Garza Ramos, C. Rory Goodwin, Amit Jain, Daniel Martinez-Ramirez, Isaac O. Karikari, Daniel M. Sciubba


Background: To investigate the inpatient perioperative morbidity rate of patients with movement disorders (MD) after spinal deformity surgery.
Methods: The Nationwide Inpatient Sample database from 2002 to 2011 was queried to identify adult patients with MD who underwent spinal deformity surgery. Complication rates were compared between patients with MD and controls. A multiple logistic regression analysis was conducted to assess the effect of MD on outcome.
Results: A total of 365 patients with MD (3.3%) were identified among 11,043 patients undergoing surgery for spinal deformity. Patients with MD were on average 8 years older than the control group (67 vs. 59 years of age, P<0.001). The complication rate was 55.1% for patients with MD and 43.7% for patients without MD (P<0.001). The most common complication was acute post-hemorrhagic anemia, which occurred in 31.9% of all patients (41.6% in MD patients and 31.5% in the control group, P<0.001). Other complications that were more common in patients with MD included delirium (P<0.001), acute kidney injury (P=0.032), and pulmonary embolism (P=0.014). After controlling for patient age, sex, osteoporosis, complex procedures, fusion to the lumbosacral spine, use of bone morphogenetic protein, and use of blood transfusion, patients with MD were 1.3 times more likely to develop a complication compared to patients without MD [odds ratio (OR), 1.27; 95% confidence interval (CI), 1.02–1.59; P=0.032] on multiple logistic regression analysis. No significant difference in hospital stay was observed.
Conclusions: Patients with MD who undergo spinal deformity surgery may be at risk of higher rate of complications compared to patients without these disorders.