K Aaron Shaw1, Keith Orland2, Tracey P Bastrom3, Peter O Newton3, Nicholas D Fletcher4. 1. Department of Orthopaedic Surgery, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA, USA. 2. Department of Pediatric Orthopaedic Surgery, Scottish Rite for Children Hospital, Dallas, TX, USA. 3. Department of Pediatric Orthopaedic Surgery, Rady Children's Hospital, San Diego, CA, USA. 4. Department of Pediatric Orthopaedic Surgery, Children's Healthcare of Atlanta, Emory University, Atlanta, GA, USA. Nicholas.d.fletcher@emory.edu.
Abstract
PURPOSE: Traditionally, 2-year follow-up data have been the established standard for reporting clinical outcomes following spinal deformity surgery. However, previous studies indicate that 2-year follow-up does not represent long-term outcomes. Currently, there is no clear data that demonstrate a difference in outcomes between the 1 and 2 years postoperative time-periods following posterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS). METHODS: A multi-center, prospective database was queried for AIS patients treated with PSF. Clinical outcome scores, assessed by SRS-22, coronal and sagittal radiographic parameters were assessed at time periods: 6 months, 1 year, and 2 years post operatively. Complications and reoperation rates were also assessed. Statistical analysis compared outcomes variables across time-points to assess for significant differences. RESULTS: 694 patients (82.6% female, mean age at surgery 14.9 ± 2.13 years) were identified. Between post-operative year 1 and 2, significant difference in SRS-22 domain scores were present for function domain (4.5 vs. 4.6; p < 0.001), mental health domain (4.3 vs. 4.2; p < 0.001), and total domain score (4.4 vs. 4.4; p = 0.03) but were below the minimal clinically important difference threshold. New complication development was significantly higher within the first year following surgery than the 1-2 year follow-up period (p < 0.001) with greater complication severity within the 0-1 year follow-up period (P = 0.03). CONCLUSION: There are no clinically important changes in SRS-22 domain scores between 1 and 2 years following PSF for AIS, with higher complications in the first year following PSF. Two-year follow-up data provide little added clinical information while under-estimating the cumulative complication and reoperation rates at long-term follow-up.
PURPOSE: Traditionally, 2-year follow-up data have been the established standard for reporting clinical outcomes following spinal deformity surgery. However, previous studies indicate that 2-year follow-up does not represent long-term outcomes. Currently, there is no clear data that demonstrate a difference in outcomes between the 1 and 2 years postoperative time-periods following posterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS). METHODS: A multi-center, prospective database was queried for AIS patients treated with PSF. Clinical outcome scores, assessed by SRS-22, coronal and sagittal radiographic parameters were assessed at time periods: 6 months, 1 year, and 2 years post operatively. Complications and reoperation rates were also assessed. Statistical analysis compared outcomes variables across time-points to assess for significant differences. RESULTS: 694 patients (82.6% female, mean age at surgery 14.9 ± 2.13 years) were identified. Between post-operative year 1 and 2, significant difference in SRS-22 domain scores were present for function domain (4.5 vs. 4.6; p < 0.001), mental health domain (4.3 vs. 4.2; p < 0.001), and total domain score (4.4 vs. 4.4; p = 0.03) but were below the minimal clinically important difference threshold. New complication development was significantly higher within the first year following surgery than the 1-2 year follow-up period (p < 0.001) with greater complication severity within the 0-1 year follow-up period (P = 0.03). CONCLUSION: There are no clinically important changes in SRS-22 domain scores between 1 and 2 years following PSF for AIS, with higher complications in the first year following PSF. Two-year follow-up data provide little added clinical information while under-estimating the cumulative complication and reoperation rates at long-term follow-up.
Authors: Benjamin D Roye; Hiroko Matsumoto; Adam N Fano; Gerard F Marciano; Rajiv R Iyer; Afrain Boby; Nicole Bainton; Lawrence G Lenke; Peter O Newton; Michael G Vitale Journal: Spine Deform Date: 2021-11-25
Authors: Ndéye F Guissé; Joseph D Stone; Lukas G Keil; Tracey P Bastrom; Mark A Erickson; Burt Yaszay; Patrick J Cahill; Stefan Parent; Peter G Gabos; Peter O Newton; Michael P Glotzbecker; Michael P Kelly; Joshua M Pahys; Nicholas D Fletcher Journal: Spine Deform Date: 2021-08-05
Authors: Nicholas D Fletcher; Tracey P Bastrom; Noelle A Larson; Stefan Parent; Baron A Lonner; Burt Yaszay; Michael P Kelly; Mark A Erickson Journal: Spine Deform Date: 2022-05-09