Background: Peri-operative adverse events (AE)
lead to patient disappointment and greater costs. There is a paucity of data
on how AEs affect long-term outcomes. The purpose of this study is to
examine peri-operative AEs and their impact on outcome after lumbar spine
surgery. Methods: 3556 consecutive patients
undergoing surgery for lumbar degenerative disorders enrolled in the
Canadian Spine Outcomes and Research Network were analyzed. AEs were defined
using the validated Spine AdVerse Events Severity system. Outcomes at 3,12,
and 24 months post-operatively included the Owestry Disability Index (ODI),
SF-12 Physical (PCS) and Mental (MCS) scales, visual analog scale (VAS) leg
and back, Euroqol-5D (EQ5D), and satisfaction.
Results: Adverse events occurred in 767 (21.6%)
patients, 85 (2.4%) suffered major AEs. Patients with major AEs had worse OD
(physical disability) scores and did not reach minimum clinically important
differences at 2 years (no AE 25.7±19.2, major: 36.4±19.1, p<0.001).
Major AEs were associated with worse ODI (physical disability) scores on
multivariable linear regression (p=0.011).
Conclusions: Major AEs after lumbar spine surgery
lead to worse functional outcomes and lower satisfaction. This highlights
the need to implement strategies aimed at reducing adverse events.