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Prevalence and Indications for Unplanned Reoperations Following Index Surgery in the Adult Symptomatic Lumbar Scoliosis NIH-Sponsored Clinical Trial
- Source :
- Spine Deformity. 6:741-744
- Publication Year :
- 2018
- Publisher :
- Springer Science and Business Media LLC, 2018.
-
Abstract
- Study Design Longitudinal cohort. Objective To report on the prevalence and indications for unplanned reoperations following index surgery in the Adult Symptomatic Lumbar Scoliosis NIH-sponsored Clinical Trial. Summary of Background Data Reoperation following adult spinal deformity surgery exposes the patient to additional surgical risk, increases the cost of care, and decreases the potential cost-effectiveness of the intervention. Accurate data regarding the prevalence and indication for reoperation will facilitate future efforts to minimize risk. Methods A total of 153 patients underwent adult spinal deformity surgery as part of the observational, randomized, or crossover groups and were eligible for two-year follow-up. Reoperations were meticulously tracked as part of the National Institutes of Health (NIH)–mandated serious adverse event (SAE) reporting. The primary indication for reoperation was obtained from the treating surgeon’s operative report. Results Thirty-two patients had one reoperation, two patients underwent two reoperations, and three patients underwent three reoperations. A total of 45 reoperations were performed in 37 patients. Eleven patients (7%) underwent reoperation within 90 days of the index surgery: two for superficial wound dehiscence, three for radiculopathy with screw removal, and six for acute proximal junctional failure (PJF). Four patients underwent reoperation for PJF more than 90 days from index surgery. Twenty-six patients underwent 28 reoperations for rod fracture/pseudoarthrosis. Conclusion In a consecutive series of adult spinal deformity surgery patients with meticulous follow-up, 24% of patients required an unplanned reoperation. The most common indication for reoperation was rod fracture/pseudoarthrosis, which occurred from 9 months to 3.7 years following the index surgery and accounted for 62% (28/45) of the reoperations. The second most common indication for reoperation was PJF, which occurred from 1 month to 1.6 years following index surgery and accounted for 22% (10/45) of the reoperations. As these complications will likely increase with longer follow-up, efforts to lower the rates of these complications are warranted. Level of Evidence Level II.
- Subjects :
- Male
Reoperation
medicine.medical_specialty
Article
03 medical and health sciences
0302 clinical medicine
medicine
Operative report
Humans
Orthopedics and Sports Medicine
Longitudinal Studies
Prospective Studies
Longitudinal cohort
Adverse effect
Aged
030222 orthopedics
Lumbar Vertebrae
Wound dehiscence
business.industry
Middle Aged
medicine.disease
Surgery
Clinical trial
Scoliosis
Orthopedic surgery
Female
Lumbar scoliosis
business
Cost of care
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 2212134X
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Spine Deformity
- Accession number :
- edsair.doi.dedup.....a708b6d74d528a10acba53a1db85a199