BACKGROUND CONTEXT: Adult scoliosis surgery is a challenging procedure with high rate of complications and reoperations. Reoperation rates vary widely. Long-term survival for this surgery still remains unknown, and the prognostic factors for reoperation are not well defined. PURPOSE: To assess adult scoliosis surgery survival (without the need of reoperation) after primary fusion in adults with mainly frontal deformity and to define prognostic factors for reoperation. STUDY DESIGN: Survival analysis of a cohort of consecutive adult patients, primarily operated on scoliosis using segmental instrumentation (retrospective cohort study). PATIENT SAMPLE: Fifty-nine patients older than 21 years at primary surgery (median age, 42 years), who presented idiopathic or degenerative curves with frontal Cobb >40° (median preoperative frontal Cobb 59°), more than four-level fusion, and a 2-year minimum postoperative follow-up (median, 8.5 years; 41% patients had a longer than 10-year follow-up). OUTCOME MEASURES: Clinical and preoperative radiographic parameters were analyzed preoperatively and evaluated as prognostic factors for reoperation. METHODS: Survival was estimated using Kaplan-Meier method. Prognostic factors (clinical and radiographic) for reoperation were evaluated. Logistic regression using backward elimination was used for multivariate analysis. RESULTS: Survival was 89.8% at 1 year, 79.4% at 2 years, 73.4% at 3 years, 64% at 5 years, and 60.9% at 10 years. Overall, 21 patients (35.6%) underwent revision surgery. The most common reasons for reoperation were painful/prominent implants, adjacent-segment degeneration, and infection. American Society of Anesthesiologists Type II patients and double surgical approach were associated with a higher revision rate. Preoperative thoracic kyphosis was significantly higher in reoperated patients. CONCLUSIONS: The 10-year survival rate of primary scoliosis surgery in adult patients is 61%. Risk factors identified for reoperation included patients with higher morbidity, double surgical approach, and preoperative thoracic hyperkyphosis.
BACKGROUND CONTEXT: Adult scoliosis surgery is a challenging procedure with high rate of complications and reoperations. Reoperation rates vary widely. Long-term survival for this surgery still remains unknown, and the prognostic factors for reoperation are not well defined. PURPOSE: To assess adult scoliosis surgery survival (without the need of reoperation) after primary fusion in adults with mainly frontal deformity and to define prognostic factors for reoperation. STUDY DESIGN: Survival analysis of a cohort of consecutive adult patients, primarily operated on scoliosis using segmental instrumentation (retrospective cohort study). PATIENT SAMPLE: Fifty-nine patients older than 21 years at primary surgery (median age, 42 years), who presented idiopathic or degenerative curves with frontal Cobb >40° (median preoperative frontal Cobb 59°), more than four-level fusion, and a 2-year minimum postoperative follow-up (median, 8.5 years; 41% patients had a longer than 10-year follow-up). OUTCOME MEASURES: Clinical and preoperative radiographic parameters were analyzed preoperatively and evaluated as prognostic factors for reoperation. METHODS: Survival was estimated using Kaplan-Meier method. Prognostic factors (clinical and radiographic) for reoperation were evaluated. Logistic regression using backward elimination was used for multivariate analysis. RESULTS: Survival was 89.8% at 1 year, 79.4% at 2 years, 73.4% at 3 years, 64% at 5 years, and 60.9% at 10 years. Overall, 21 patients (35.6%) underwent revision surgery. The most common reasons for reoperation were painful/prominent implants, adjacent-segment degeneration, and infection. American Society of Anesthesiologists Type IIpatients and double surgical approach were associated with a higher revision rate. Preoperative thoracic kyphosis was significantly higher in reoperated patients. CONCLUSIONS: The 10-year survival rate of primary scoliosis surgery in adult patients is 61%. Risk factors identified for reoperation included patients with higher morbidity, double surgical approach, and preoperative thoracic hyperkyphosis.
Authors: D Kojo Hamilton; Adam S Kanter; Bryan D Bolinger; Gregory M Mundis; Stacie Nguyen; Praveen V Mummaneni; Neel Anand; Richard G Fessler; Peter G Passias; Paul Park; Frank La Marca; Juan S Uribe; Michael Y Wang; Behrooz A Akbarnia; Christopher I Shaffrey; David O Okonkwo Journal: Eur Spine J Date: 2016-02-24 Impact factor: 3.134
Authors: Charles H Crawford; Steven D Glassman; Leah Y Carreon; Christopher I Shaffrey; Tyler R Koski; Christine R Baldus; Keith H Bridwell Journal: Spine Deform Date: 2018 Nov - Dec
Authors: Robert K Eastlack; Ravi Srinivas; Gregory M Mundis; Stacie Nguyen; Praveen V Mummaneni; David O Okonkwo; Adam S Kanter; Neel Anand; Paul Park; Pierce Nunley; Juan S Uribe; Behrooz A Akbarnia; Dean Chou; Vedat Deviren Journal: Global Spine J Date: 2018-05-10