@article{4d35f10ad8b64aa9b9ea152735908b7d,
title = "Prospective multicenter assessment of all-cause mortality following surgery for adult cervical deformity",
abstract = "BACKGROUND Surgical treatments for adult cervical spinal deformity (ACSD) are often complex and have high complication rates. OBJECTIVE To assess all-cause mortality following ACSD surgery. METHODS ACSD patients presenting for surgical treatment were identified from a prospectively collected multicenter database. Clinical and surgical parameters and all-cause mortality were assessed. RESULTS Of 123 ACSD patients, 120 (98%) had complete baseline data (mean age, 60.6 yr). The mean number of comorbidities per patient was 1.80, and 80% had at least 1 comorbidity. Surgical approaches included anterior only (15.8%), posterior only (50.0%), and combined anterior/posterior (34.2%). The mean number of vertebral levels fused was 8.0 (standard deviation [SD] = 4.5), and 23.3% had a 3-column osteotomy. Death was reported for 11 (9.2%) patients at a mean of 1.1 yr (SD = 0.76 yr; range = 7 d to 2 yr). Mean follow-up for living patients was 1.2 yr (SD = 0.64 yr). Causes of death included myocardial infarction (n = 2), pneumonia/cardiopulmonary failure (n = 2), sepsis (n = 1), obstructive sleep apnea/narcotics (n = 1), subsequently diagnosed amyotrophic lateral sclerosis (n = 1), burn injury related to home supplemental oxygen (n = 1), and unknown (n = 3). Deceased patients did not significantly differ from alive patients based on demographic, clinical, or surgical parameters assessed, except for a higher major complication rate (excluding mortality; 63.6% vs 22.0%, P =.006). CONCLUSION All-cause mortality at a mean of 1.2 yr following surgery for ACSD was 9.2% in this prospective multicenter series. Causes of death were reflective of the overall high level of comorbidities. These findings may prove useful for treatment decision making and patient counseling in the context of the substantial impact of ACSD.",
keywords = "Adult, Cervical deformity, Mortality, Surgery",
author = "Smith, {Justin S.} and Shaffrey, {Christopher I.} and Kim, {Han Jo} and Peter Passias and Themistocles Protopsaltis and Renaud Lafage and Mundis, {Gregory M.} and Eric Klineberg and Virginie Lafage and Schwab, {Frank J.} and Scheer, {Justin K.} and Emily Miller and Michael Kelly and Hamilton, {D. Kojo} and Munish Gupta and Vedat Deviren and Richard Hostin and Todd Albert and Riew, {K. Daniel} and Robert Hart and Doug Burton and Shay Bess and Ames, {Christopher P.}",
note = "Funding Information: The International Spine Study Group (ISSG) is funded through research grants from DePuy Synthes. Dr Smith has the following disclosures: Zimmer Biomet—consultant, honorarium for teaching, royalties; Nuvasive—consultant, honorarium for teaching; AlloSource—consultant; Depuy Synthes—research grants to study group; K2M—consultant, honorarium for teaching; AOSpine— fellowship funding; NREF—fellowship funding. Dr Shaffrey has the following disclosures: Medtronic—royalties, patents, consultant; Nuvasive—royalties, patents, consultant, stock holder; Zimmer Biomet—royalties, patents, consultant; K2M—consultant; Stryker—consultant; In Vivo—consultant; NIH—grants; Department of Defense-grants; ISSG—grants; DePuy Synthes—grants; AO— grants. Dr Kim has the following disclosures: K2M—consultant; Zimmer Biomet—consultant; ISSGF—research funding; CSRS—research funding; HSS Journal—board membership; ASJ—board membership; GSJ—board membership. Dr Passias is a consultant for Medicrea. Dr Protopsaltis is a consultant for Medicrea, NuVasive, Globus, and Innovasis and receives research support from Zimmer Spine and the Cervical Spine Research Society. Dr Mundis has the following disclosures: Nuvasive—consulting, royalties, research funding (not paid to Dr Mundis); K2M—consulting, royalties; DePuy Synthes— honorarium; DePuy Synthes/ISSG—research funding (not paid to Dr Mundis). Dr Klineberg has the following disclosures: DePuy—consulting; Stryker— consulting; AOSpine—paid speaker, fellowship support; K2M—paid speaker. Dr Lafage has the following disclosures: Depuy Synthes—paid lectures; Publisher Copyright: Copyright {\textcopyright} 2018 by the Congress of Neurological Surgeons.",
year = "2018",
month = dec,
day = "1",
doi = "10.1093/neuros/nyx605",
language = "English (US)",
volume = "83",
pages = "1277--1285",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "6",
}