What potential complications are associated with scoliosis surgery

The risks of perioperative complications have diminished with modern techniques of anesthesia, intraoperative neurophysiologic monitoring, improved spinal instrumentation systems, and enhanced postoperative intensive care and pain management. However, patients must be informed of the most common complications, including but not exclusively limited to hemorrhage, infection, pseudarthrosis, implant misplacement or construct failure, trunk imbalance, neurologic injury, and the possible need for future surgery to treat these problems.

Key Points

1. Idiopathic scoliosis is classified according to age at onset into infantile (birth-3 years), juvenile (3-10 years), and adolescent (after 10 years) subtypes.

2. Idiopathic scoliosis is a diagnosis of exclusion and requires thorough evaluation to rule out an underlying congenital, neurologic, or syndromic etiology.

3. The management options for patients diagnosed with idiopathic scoliosis include observation, orthoses, and operative treatment.

Websites

Spinal deformity: http://www.boneandjointburden.org/pdfs/BMUS_chpt3_spinal%20deformity.pdf Idiopathic scoliosis: http://www.posna.org/education/StudyGuide/idiopathicScoliosisGreaterThan40.asp Adolescent idiopathic scoliosis: http://www.srs.org/professionals/education/adolescent/idiopathic/ Genetic test for scoliosis: http://www.scoliscore.com/

BiBLiOGRAPHY

1. Asher MA, Burton DC. A concept of idiopathic scoliosis deformities as imperfect torsion(s). Clin Orthop Rel Res 1999;364:11-25.

2. Collis DK, Ponsetti IV. Long-term follow-up of patients with idiopathic scoliosis not treated surgically. J Bone Joint Surg 1969;51:425-45.

3. King HA, Moe JH, Bradford DS, et al. The selection of fusion levels in thoracic idiopathic scoliosis. J Bone Joint Surg 1983;65A:1302-13.

4. Lenke LG, Betz RR, Harms J, et al. Adolescent idiopathic scoliosis—a new classification to determine extent of spinal arthrodesis. J Bone Joint Surg 2001;83A:1169-81.

5. Lenke LG, Dobbs MB. Management of juvenile idiopathic scoliosis. J Bone Joint Surg 2007;89A:S55-S63.

6. Lenke LG, Kuklo TR, Ondra S, et al. Rationale behind the current state of the art treatment of scoliosis in the pedicle screw era. Spine 2008;33:1051-4.

7. Lonstein JE, Carlson JM. The prediction of curve progression in untreated idiopathic scoliosis during growth. J Bone Joint Surg 1984;66A:1061-71.

8. Sanders JO. Maturity indicators in spinal deformity. J Bone Joint Surg 2007;89A:S14-S20.

9. Suk SI, Lee SM, Chung ER, et al. Selective thoracic fusion with segmental pedicle screw fixation in the treatment of thoracic idiopathic scoliosis: more than 5-year follow-up. Spine 2005;30:1602-9.

10. Sponseller PD, Betz R, Newton PO, et al. Differences in curve behavior after fusion in adolescent idiopathic scoliosis patients with open triradiate cartilages. Spine 2009;34:827-31.

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