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Peer-reviewedCC BY-NC-NDBone & joint open

Adverse events in paediatric spinal deformity surgery - 12-year review of specialist spinal deformity practice.

5 affiliations
  1. 1Sheffield Children's NHS Foundation Trust, Sheffield, UK.
  2. 2Nottingham University Hospitals NHS Trust, Nottingham, UK.
  3. 3Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
  4. 4The Medical School, The University of Sheffield, Sheffield, UK.
  5. 5Royal Free London NHS Foundation Trust, London, UK.

Abstract

Aims

Adverse events following paediatric spinal deformity surgery in the UK suffers from significant reporting gaps, as current data relies predominantly on voluntary incident submissions. This retrospective study aims to comprehensively assess the incidence of all surgical adverse events at a specialized paediatric spinal orthopaedic centre.Methods

A retrospective review of prospectively collected data from January 2010 to December 2022 systematically evaluated perioperative and postoperative adverse events. Patients were analyzed by scoliosis aetiology and adverse events were stratified according to the Clavien-Dindo classification system. Adverse events were further grouped by common themes including implant-related, infection-related, and neurological events.Results

A total of 871 paediatric spinal deformity patients undergoing 1,020 operations with at least two years follow-up were identified. Adolescent idiopathic scoliosis was the most common primary pathology with 545 patients (62.6%). Overall, 324 patients (37.2%) experienced an adverse event. Adverse events were categorized by severity: 14.8% grade 1, 5.3% grade 2, 1.1% grade 3A, 14.6% grade 3B, 1.1% grade 4, and 0.1% grade 5. Implant-related issues were most frequent (n = 113, 13.0%), followed by curve progression (n = 33, 3.8%) and persistent pain (n = 33, 3.8%). Neurological events included four complete cord injuries (0.5%) and four incomplete cord injuries which fully recovered (0.5%). One perioperative death occurred.Conclusion

In this cohort of paediatric spinal deformity surgeries, over one-third of patients experienced adverse events, predominantly of low severity requiring minimal or no further intervention. Implant-related adverse events were most frequent, while the incidence of both complete and incomplete spinal cord injury, as well as mortality, remained reassuringly low across all procedures.

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BibTeX
@article{bayley2026adverse,
  title = {{Adverse events in paediatric spinal deformity surgery - 12-year review of specialist spinal deformity practice.}},
  author = {Edward J Bayley and Shreya Srinivas and Matthew Bellamy and Adya Ranjan and Dominic M Luttrell and Michael Athanassacopoulos and Anthony L R Michael and Lee M Breakwell and Ashley A Cole},
  journal = {Bone \& joint open},
  year = {2026},
  month = oct,
  doi = {10.1302/2633-1462.710.bjo-2026-0057.r1},
  url = {https://europepmc.org/article/MED/42901500},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Adverse events in paediatric spinal deformity surgery - 12-year review of specialist spinal deformity practice.
AU  - Edward J Bayley
AU  - Shreya Srinivas
AU  - Matthew Bellamy
AU  - Adya Ranjan
AU  - Dominic M Luttrell
AU  - Michael Athanassacopoulos
AU  - Anthony L R Michael
AU  - Lee M Breakwell
AU  - Ashley A Cole
PY  - 2026
DA  - 2026/10/21
JO  - Bone & joint open
DO  - 10.1302/2633-1462.710.bjo-2026-0057.r1
UR  - https://europepmc.org/article/MED/42901500
AB  - Aims  Adverse events following paediatric spinal deformity surgery in the UK suffers from significant reporting gaps, as current data relies predominantly on voluntary incident submissions. This retrospective study aims to comprehensively assess the incidence of all surgical adverse events at a specialized paediatric spinal orthopaedic centre.Methods  A retrospective review of prospectively collected data from January 2010 to December 2022 systematically evaluated perioperative and postoperative adverse events. Patients were analyzed by scoliosis aetiology and adverse events were stratified according to the Clavien-Dindo classification system. Adverse events were further grouped by common themes including implant-related, infection-related, and neurological events.Results  A total of 871 paediatric spinal deformity patients undergoing 1,020 operations with at least two years follow-up were identified. Adolescent idiopathic scoliosis was the most common primary pathology with 545 patients (62.6%). Overall, 324 patients (37.2%) experienced an adverse event. Adverse events were categorized by severity: 14.8% grade 1, 5.3% grade 2, 1.1% grade 3A, 14.6% grade 3B, 1.1% grade 4, and 0.1% grade 5. Implant-related issues were most frequent (n = 113, 13.0%), followed by curve progression (n = 33, 3.8%) and persistent pain (n = 33, 3.8%). Neurological events included four complete cord injuries (0.5%) and four incomplete cord injuries which fully recovered (0.5%). One perioperative death occurred.Conclusion  In this cohort of paediatric spinal deformity surgeries, over one-third of patients experienced adverse events, predominantly of low severity requiring minimal or no further intervention. Implant-related adverse events were most frequent, while the incidence of both complete and incomplete spinal cord injury, as well as mortality, remained reassuringly low across all procedures.
SN  - 2633-1462
ER  -