Changing the adverse event profile in metastatic spine surgery: An evidence based approach to target wound complications and instrumentation failure

Addisu Mesfin, Daniel Sciubba, Nicolas Dea, Anick Nater, Justin Bird, Nasir A. Quraishi, Charles G. Fisher, John Shin, Michael G. Fehlings, Naresh Kumar, Michelle Clarke

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

STUDY DESIGN.: Systematic review OBJECTIVE.: To identify risk factors and preventive methods for wound complications and instrumentation failure following metastatic spine surgery. SUMMARY OF BACKGROUND DATA.: We focused on two post-operative complications of metastatic spine tumor surgery: wound complications and instrumentation failure and preventive measures. METHODS.: We performed a systematic review of the literature from 1980 to 2015. The articles were analyzed for the presence of documented infection and/or wound complications and instrumentation failure. RESULTS.: Forty articles met our inclusion criteria for wound complications and prevention. There is very low level of evidence that pre-operative radiation, pre-operative neurological deficit, revision procedures and posterior approaches can contribute to wound complications (infections, wound dehiscence). There is very low level of evidence that plastic surgery soft tissue reconstruction, intrawound vancomycin powder and percutaneous pedicle screws may prevent post-operative wound complications. Fourteen articles met our inclusion criteria for instrumentation failure. There is very low level of evidence that constructs greater than six levels, positive sagittal balance, pre-operative radiation and history of chest wall resection can contribute to implant failures. CONCLUSION.: Level of Evidence: 4

Original languageEnglish (US)
JournalSpine
DOIs
StateAccepted/In press - Aug 8 2016

ASJC Scopus subject areas

  • Medicine(all)
  • Orthopedics and Sports Medicine
  • Clinical Neurology

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    Mesfin, A., Sciubba, D., Dea, N., Nater, A., Bird, J., Quraishi, N. A., Fisher, C. G., Shin, J., Fehlings, M. G., Kumar, N., & Clarke, M. (Accepted/In press). Changing the adverse event profile in metastatic spine surgery: An evidence based approach to target wound complications and instrumentation failure. Spine. https://doi.org/10.1097/BRS.0000000000001817