{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:11:34Z","timestamp":1792098694447,"version":"4.4.0"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2017,7,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Reporting accurate surgical complication rates to patients and their families is important in the management of adolescent idiopathic scoliosis (AIS). In this study, we report the rate of major complications following the surgical treatment of AIS both in the perioperative period and among patients with a minimum of 2 years of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We reviewed the prospectively collected data of a multicenter registry of patients who underwent surgical treatment of AIS during the period of 1995 to 2014 in order to identify all complications. A complication was defined as \u201cmajor\u201d if it resulted in reoperation or in spinal cord or nerve root injury, or was life-threatening. A total of 3,582 patients with preoperative and early postoperative data (4 to 6 weeks of follow-up) were included. A subset of 2,220 patients with a minimum of 2 years of follow-up comprised the cohort for delayed complications. Overall complication rates were calculated, as was the percentage of complications according to the year of the index surgery and type of surgical approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean age of the 3,582 patients at the time of surgery was 14.8 \u00b1 2.2 years. The average major curve magnitude was 56\u00b0 \u00b1 13\u00b0 for thoracic curves and 51\u00b0 \u00b1 11\u00b0 for lumbar. In 365 patients, anterior spinal fusion (ASF) with instrumentation was performed, and in 3,217 patients, posterior spinal fusion (PSF) with instrumentation was performed; 142 patients in the PSF group underwent concomitant anterior release. There were 192 major complications, with 93 (2.6%) occurring perioperatively. Perioperative complications included wound-related (1.0% of the patients), neurologic (0.5%), pulmonary (0.4%), instrumentation-related (0.4%), and gastrointestinal (0.2%) complications. One patient died. The mean annual perioperative major complication rate based on the year of surgery ranged from 0% to 10.5%. The complication rate by surgical approach was 3.0% for ASF and 2.6% for PSF (2.4% for PSF only and 5.6% for PSF with anterior release). The major complication rate for the 2,220 patients with at least 2 years of follow-up was 4.1%; all but 1 had a reoperation (4.1%). The majority of these major complications were wound and instrumentation-related (1.9% and 0.8%, respectively).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>After surgery for AIS, a 2.6% rate of perioperative major complications and a 4.1% rate of major complications at 2 or more years after surgery can be anticipated. The complication rate decreased over the period of study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.16.01331","type":"journal-article","created":{"date-parts":[[2017,7,19]],"date-time":"2017-07-19T12:17:52Z","timestamp":1500466672000},"page":"1206-1212","source":"Crossref","is-referenced-by-count":103,"title":["Perioperative and Delayed Major Complications Following Surgical Treatment of Adolescent Idiopathic Scoliosis"],"prefix":"10.2106","volume":"99","author":[{"given":"Carrie E.","family":"Bartley","sequence":"first","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Burt","family":"Yaszay","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey P.","family":"Bastrom","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suken A.","family":"Shah","sequence":"additional","affiliation":[{"name":"Nemours Alfred I. duPont Hospital for Children, Wilmington, Delaware"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baron S.","family":"Lonner","sequence":"additional","affiliation":[{"name":"Scoliosis and Spine Associates, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jahangir","family":"Asghar","sequence":"additional","affiliation":[{"name":"Nicklaus Children\u2019s Hospital, Miami, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Firoz","family":"Miyanji","sequence":"additional","affiliation":[{"name":"British Columbia Children\u2019s Hospital, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amer","family":"Samdani","sequence":"additional","affiliation":[{"name":"Shriner\u2019s Hospitals for Children Philadelphia, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter O.","family":"Newton","sequence":"additional","affiliation":[{"name":"Rady Children\u2019s Hospital, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"11","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1097\/BRS.0b013e318053d537","article-title":"Pay-for-performance: considerations in application to the management of spinal disorders","volume":"32","author":"Berven","year":"2007","journal-title":"Spine (Phila Pa 1976)."},{"issue":"2","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"144","DOI":"10.3171\/2010.3.SPINE09369","article-title":"Complications in spine surgery","volume":"13","author":"Nasser","year":"2010","journal-title":"J Neurosurg Spine."},{"issue":"3","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1007\/s11999-009-1026-0","article-title":"Radiographic classification of complications of instrumentation in adolescent idiopathic scoliosis","volume":"468","author":"Flynn","year":"2010","journal-title":"Clin Orthop Relat Res."},{"issue":"11","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.2106\/00004623-200711000-00013","article-title":"Non-neurologic complications following surgery for adolescent idiopathic scoliosis","volume":"89","author":"Carreon","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1097\/01.brs.0000197188.76369.13","article-title":"Complications in spinal fusion for adolescent idiopathic scoliosis in the new millennium. 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