論文ID: 2025-0082
Introduction: The Japanese Scoliosis Society conducted a survey on the complications of pediatric spinal deformity surgeries in 2012, 2014, and 2017. However, a registry-based survey was necessary to systematically and comprehensively identify complications, and a web-based registry system was established. This study aimed to investigate the frequency of pediatric spinal deformity surgeries and perioperative complications in Japan in 2022, using a web-based registry.
Methods: Of the 158,263 cases collected from 1,032 institutions, 1,945 (485 boys and 1,460 girls) were included in the study. The diagnoses were idiopathic scoliosis (64.9%), congenital scoliosis (10.1%), neuromuscular scoliosis (7.4%), congenital kyphoscoliosis (1.1%), and others (16.5%). The intraoperative, postoperative (within 30 days), and systemic (within 30 days postoperatively) complications were investigated.
Results: The overall complication rate was 6.0% (intraoperative, 2.5%; postoperative, 2.4%; and systemic, 2.0%). The complication rates by diagnosis were highest in congenital kyphosis (25.0%), followed by congenital kyphoscoliosis (18.2%) and neuromuscular scoliosis (13.3%), whereas idiopathic scoliosis (10-18 years old) had a complication rate of 3.7%. The most common intraoperative complications were massive bleeding (>2,000 mL) in 0.9%, dural tears in 0.7%, and nerve injury in 0.2% of the patients. The most frequent postoperative complications were neurologic deficits (0.8%), surgical site infections (0.8%), and implant failure (0.5%). The most frequent postoperative systemic complications were respiratory (0.6%) and urinary (0.4%).
Conclusions: This nationwide web-based registry study provides a highly comprehensive report on pediatric scoliosis surgery in Japan in 2022. The complication rates were notably high for congenital kyphosis, congenital kyphoscoliosis, and neuromuscular scoliosis. These findings may help improve patient and family understanding of the risks associated with various spinal deformities and support shared decision-making in pediatric surgical care.
