The Surgical and Medical Perioperative Complications of Anterior Spinal Fusion Surgery in the Thoracic and Lumbar Spine in Adults: A Review of 1223 Procedures

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Study Design

A retrospective review of 1223 thoracic and lumbar anterior spinal fusions was performed from 1969 through 1992.


To document the incidence and specific types of perspective complications related to anterior spinal fusions.

Summary of Background Data

Despite the increased use of anterior spinal surgery, there has been little documentation of the specific types and frequencies of the complications associated with its use.


All Minnesota Spine Center patients age 18 years or older who had anterior spinal fusions between the levels of T1 and S1 from August 1969 to June 1992 were reviewed for the occurrence of perioperative complications. Surgical approach and technique and associated comorbidity was recorded.


The risk of a complication was increased for patients over age 60 years, for women, and for patients with multiple preexisting health problems. Serious complications, such as death (0.3%), paraplegia (0.2%), and deep wound infection (0.6%) were rare. The complication rate for complications that were directly attributed to the anterior spinal surgery was 11.5%.


Anterior spinal fusion surgery is a safe procedure and can be used with confidence when the nature of a patient's spinal disorder dictates its use. Complications are often approach specific.

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