{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T22:41:46Z","timestamp":1793054506250,"version":"4.5.0"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["PED"],"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The Nationwide Inpatient Sample database was used to identify patients 10\u201318 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development. Results of multiple logistic regression analyses were reported as odds ratios with 95% confidence intervals. All analyses were performed after the application of discharge weights to produce national estimates.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 36,335 patients met the study inclusion criteria, 7.6% of whom (95% CI 6.3%\u20138.9%) developed at least one in-hospital complication. The 3 most common complications were respiratory failure (3.47%), reintubation (1.27%), and implant related (1.14%). Major complications such as death, pancreatitis, disseminated intravascular coagulation, visual loss, spinal cord injury, cardiac arrest, sepsis, nerve root injury, deep vein thrombosis, pulmonary embolism, shock, malignant hyperthermia, myocardial infarction, and iatrogenic stroke each had an incidence \u2264 0.2%. On multiple logistic regression analysis, an increasing age (OR 0.80) was associated with significantly lower odds of complication development; patients who were male (OR 1.80) or who had anemia (OR 2.10), hypertension (OR 2.51), or hypothyroidism (OR 2.27) or underwent revision procedures (OR 5.55) were at a significantly increased risk for complication development. The rates of postoperative complications for posterior, anterior, and combined approaches were 6.7%, 10.0%, and 19.8%, respectively (p &lt; 0.001). Length of fusion (&lt; 8 vs \u2265 8 levels) was not associated with complication development (p = 0.311).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Analysis of 36,335 patients who had undergone surgery for AIS revealed that younger patients, male patients, patients with a history of anemia, hypertension, or hypothyroidism, as well as those undergoing revision or anterior or combined approaches may have higher rates of postoperative complications. However, the overall complication rate was low (7.6%), and major complications had a rate \u2264 0.2% for each event. These findings suggest that surgery for AIS remains relatively safe, and future prospective investigations may further help to decrease the postoperative morbidity rate.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2016.6.peds16200","type":"journal-article","created":{"date-parts":[[2016,8,26]],"date-time":"2016-08-26T13:59:48Z","timestamp":1472219988000},"page":"730-736","source":"Crossref","is-referenced-by-count":68,"title":["Patient and operative factors associated with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the Nationwide Inpatient Sample"],"prefix":"10.3171","volume":"18","author":[{"given":"Rafael","family":"De la Garza Ramos","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Rory","family":"Goodwin","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Abu-Bonsrah","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Jain","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"Miller","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Huang","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaled M.","family":"Kebaish","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Sponseller","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Sciubba","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"19 Suppl","key":"b1-peds16200","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"S106","DOI":"10.1097\/01.brs.0000232713.69342.df","article-title":"Medical complications of surgical treatment of adult spinal deformity and how to avoid them","volume":"31","author":"Baron","year":"2006"},{"key":"b2-peds16200","series-title":"Spine Deform","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.jspd.2014.06.008","article-title":"Incidence and risk factors for major surgical complications in patients with complex spinal deformity: a report from an SRS GOP site","volume":"3","author":"Boachie-Adjei","year":"2015"},{"key":"b3-peds16200","series-title":"J Bone Joint Surg Am","first-page":"2089","article-title":"Perioperative complications of posterior lumbar decompression and arthrodesis in older adults","volume":"85-A","author":"Carreon","year":"2003"},{"key":"b4-peds16200","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","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"},{"key":"b5-peds16200","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/s00586-015-3968-0","article-title":"Comparison of combined anterior-posterior approach versus posterior-only approach in treating adolescent idiopathic scoliosis: a meta-analysis","volume":"25","author":"Chen","year":"2016"},{"key":"b6-peds16200","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1097\/BRS.0b013e3182217ab5","article-title":"Major complications in revision adult deformity surgery: risk factors and clinical outcomes with 2- to 7-year follow-up","volume":"37","author":"Cho","year":"2012"},{"key":"b7-peds16200","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","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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