Different types of mechanical complications after surgical correction of adult spine deformity with osteotomy

Table 8 Risk factors for different mechanical complications of spine after surgical correction of adult spinal deformity with osteotomy

Mechanical complication of spine	Risk factors	OR (95%Cl: min; max)	P value	Predictive values
				Sn	Sp	+PV	-PV
Vertebral fracture	Current smoking	5.7 (1.7; 19.1)	0.008	0.37	0.91	0.50	0.85
	Type of osteotomy: SPO vs PSO	0.25 (0.1; 0.8)	0.020	0.21	0.48	0.09	0.71
	Fall after operation before mechanical complication	4.3 (1.3; 14.5)	0.024	0.32	0.89	0.43	0.84
	Integral index by multiple regression modeling (1) ≥ 0.46	11.7 (2.2;61.5)	< 0.001	0.83	0.70	0.45	0.93
Proximal junctional failure	Current smoking	4.2 (1.0; 016.8)	0.055	0.36	0.88	0.29	0.91
	Osteoporosis/osteopenia	3.19 (0.9; 11.3)	0.075	0.55	0.72	0.21	0.92
	PSO and > 5 levels fused in osteoporosis/osteopenia	10.4 (0.8; 137.8)	0.039	1.00	0.84	0.29	1.00
	Fall after operation before mechanical complication	4.2 (1.0; 16.8)	0.055	0.36	0.88	0.29	0.91
	Reoperation vs primary operation	20.1 (2.5; 163.6)	< 0.001	0.92	0.65	0.28	0.98
	Type of osteotomy: SPO vs PSO	0.23 (0.05; 1.1)	0.048	0.18	0.51	0.05	0.82
	Integral index by multiple regression modeling (1) ≥ 0.46	4.6 (0.4; 47.3)	0.167	0.75	0.60	0.14	0.97
Distal segmental degeneration/ failure	Preoperative LL ≤ 20°	20.9 (2.3; 190.6)	0.002	0.83	0.81	0.23	0.99
	Thoracolumbar crossing junction	18.6 (2.0; 164.9)	0.004	0.83	0.78	0.21	0.99
	Fixation to sacrum or pelvic	0.08 (0.01; 0.73)	0.001	0.14	0.33	0.02	0.83
	Integral index by multiple regression modeling (1) ≥ 0.46	2.9 (0.1; 89.1)	0.186	0.67	0.59	0.05	0.98

PSO: Pedicle subtraction osteotomy; SPO: Smith-Peterson osteotomy; OR: Odds ratio; 95%Cl: min; max: 95% confidence limits with minimum and maximum values; Sn: Sensitivity; Sp: Specificity; +PV: Positive predictive value; -PV: Negative predictive value; LL: Lumbar lordosis.