Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery

Samuel K. Cho, Keith H. Bridwell, Lawrence G. Lenke, Woojin Cho, Lukas P. Zebala, Joshua M. Pahys, Matthew M. Kang, Jin Seok Yi, Christine R. Baldus

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Study Design: A retrospective case comparison study. Objective: We compared clinical outcome and complications in adult patients who underwent primary (P) versus revision (R) scoliosis surgery. Summary of Background Data: There is a paucity of data comparing P versus R adult scoliosis patients with respect to their complication rates and clinical outcome. Methods: Assessment of 250 consecutive adult patients who underwent P versus R surgery for idiopathic or de novo scoliosis between 2002 and 2007, with a minimum 2-year follow-up, was performed. Results: There were 126 patients in the P group and 124 in the R group. Mean age at surgery (P = 51.2 vs. R = 51.6 years, P = 0.79), length of follow-up (P = 3.6 vs. R = 3.6 years, P = 0.94), comorbidities (P = 0.43), and smoking status (P = 0.98) were similar between the 2 groups. Body mass index (P = 25.5 vs. R = 27.4 kg/m, P = 0.01), number of final instrumented levels (P = 10.5 vs. R 12.1 levels, P = 0.00), fusion to the sacrum (P = 61.0% vs. R = 87.1%, P = 0.00), osteotomy (P = 14.3% vs. R = 54.9%, P = 0.00), length of surgery (P = 6.5 vs. R = 8.2 hours, P = 0.00), and estimated blood loss (P = 1072.1 vs. R = 1401.3 mL, P = 0.05) were different. Primary patients had significantly lower overall complications than revision patients (P = 45.2% vs. R = 58.2%, P = 0.042). Primary patients reported significantly higher preoperative and final clinical outcome measures in function, pain, and subscore SRS domains and ODI compared with revision patients (all P < 0.05). Patients older than 60 years of age, however, reported similar SRS and ODI scores between the 2 groups. The extent of surgical benefit patients received, that is, final minus preoperative score, was similar in all categories between the 2 groups. Conclusion: Adult patients undergoing primary scoliosis surgery had significantly lower overall complications compared with revision patients. Primary patients reported higher preoperative and final clinical outcome measures than revision patients, although this difference disappeared in older patients. The benefit of surgery was similar between the 2 groups.

Original languageEnglish (US)
Pages (from-to)393-401
Number of pages9
JournalSpine
Volume37
Issue number5
DOIs
StatePublished - Mar 1 2012
Externally publishedYes

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Scoliosis
Outcome Assessment (Health Care)
Sacrum
Osteotomy
Case-Control Studies
Comorbidity

Keywords

  • Clinical outcome
  • complications
  • primary surgery
  • revision surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Cho, S. K., Bridwell, K. H., Lenke, L. G., Cho, W., Zebala, L. P., Pahys, J. M., ... Baldus, C. R. (2012). Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. Spine, 37(5), 393-401. https://doi.org/10.1097/BRS.0b013e31821f0126

Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. / Cho, Samuel K.; Bridwell, Keith H.; Lenke, Lawrence G.; Cho, Woojin; Zebala, Lukas P.; Pahys, Joshua M.; Kang, Matthew M.; Yi, Jin Seok; Baldus, Christine R.

In: Spine, Vol. 37, No. 5, 01.03.2012, p. 393-401.

Research output: Contribution to journalArticle

Cho, SK, Bridwell, KH, Lenke, LG, Cho, W, Zebala, LP, Pahys, JM, Kang, MM, Yi, JS & Baldus, CR 2012, 'Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery', Spine, vol. 37, no. 5, pp. 393-401. https://doi.org/10.1097/BRS.0b013e31821f0126
Cho, Samuel K. ; Bridwell, Keith H. ; Lenke, Lawrence G. ; Cho, Woojin ; Zebala, Lukas P. ; Pahys, Joshua M. ; Kang, Matthew M. ; Yi, Jin Seok ; Baldus, Christine R. / Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. In: Spine. 2012 ; Vol. 37, No. 5. pp. 393-401.
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abstract = "Study Design: A retrospective case comparison study. Objective: We compared clinical outcome and complications in adult patients who underwent primary (P) versus revision (R) scoliosis surgery. Summary of Background Data: There is a paucity of data comparing P versus R adult scoliosis patients with respect to their complication rates and clinical outcome. Methods: Assessment of 250 consecutive adult patients who underwent P versus R surgery for idiopathic or de novo scoliosis between 2002 and 2007, with a minimum 2-year follow-up, was performed. Results: There were 126 patients in the P group and 124 in the R group. Mean age at surgery (P = 51.2 vs. R = 51.6 years, P = 0.79), length of follow-up (P = 3.6 vs. R = 3.6 years, P = 0.94), comorbidities (P = 0.43), and smoking status (P = 0.98) were similar between the 2 groups. Body mass index (P = 25.5 vs. R = 27.4 kg/m, P = 0.01), number of final instrumented levels (P = 10.5 vs. R 12.1 levels, P = 0.00), fusion to the sacrum (P = 61.0{\%} vs. R = 87.1{\%}, P = 0.00), osteotomy (P = 14.3{\%} vs. R = 54.9{\%}, P = 0.00), length of surgery (P = 6.5 vs. R = 8.2 hours, P = 0.00), and estimated blood loss (P = 1072.1 vs. R = 1401.3 mL, P = 0.05) were different. Primary patients had significantly lower overall complications than revision patients (P = 45.2{\%} vs. R = 58.2{\%}, P = 0.042). Primary patients reported significantly higher preoperative and final clinical outcome measures in function, pain, and subscore SRS domains and ODI compared with revision patients (all P < 0.05). Patients older than 60 years of age, however, reported similar SRS and ODI scores between the 2 groups. The extent of surgical benefit patients received, that is, final minus preoperative score, was similar in all categories between the 2 groups. Conclusion: Adult patients undergoing primary scoliosis surgery had significantly lower overall complications compared with revision patients. Primary patients reported higher preoperative and final clinical outcome measures than revision patients, although this difference disappeared in older patients. The benefit of surgery was similar between the 2 groups.",
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AU - Zebala, Lukas P.

AU - Pahys, Joshua M.

AU - Kang, Matthew M.

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N2 - Study Design: A retrospective case comparison study. Objective: We compared clinical outcome and complications in adult patients who underwent primary (P) versus revision (R) scoliosis surgery. Summary of Background Data: There is a paucity of data comparing P versus R adult scoliosis patients with respect to their complication rates and clinical outcome. Methods: Assessment of 250 consecutive adult patients who underwent P versus R surgery for idiopathic or de novo scoliosis between 2002 and 2007, with a minimum 2-year follow-up, was performed. Results: There were 126 patients in the P group and 124 in the R group. Mean age at surgery (P = 51.2 vs. R = 51.6 years, P = 0.79), length of follow-up (P = 3.6 vs. R = 3.6 years, P = 0.94), comorbidities (P = 0.43), and smoking status (P = 0.98) were similar between the 2 groups. Body mass index (P = 25.5 vs. R = 27.4 kg/m, P = 0.01), number of final instrumented levels (P = 10.5 vs. R 12.1 levels, P = 0.00), fusion to the sacrum (P = 61.0% vs. R = 87.1%, P = 0.00), osteotomy (P = 14.3% vs. R = 54.9%, P = 0.00), length of surgery (P = 6.5 vs. R = 8.2 hours, P = 0.00), and estimated blood loss (P = 1072.1 vs. R = 1401.3 mL, P = 0.05) were different. Primary patients had significantly lower overall complications than revision patients (P = 45.2% vs. R = 58.2%, P = 0.042). Primary patients reported significantly higher preoperative and final clinical outcome measures in function, pain, and subscore SRS domains and ODI compared with revision patients (all P < 0.05). Patients older than 60 years of age, however, reported similar SRS and ODI scores between the 2 groups. The extent of surgical benefit patients received, that is, final minus preoperative score, was similar in all categories between the 2 groups. Conclusion: Adult patients undergoing primary scoliosis surgery had significantly lower overall complications compared with revision patients. Primary patients reported higher preoperative and final clinical outcome measures than revision patients, although this difference disappeared in older patients. The benefit of surgery was similar between the 2 groups.

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