TY - JOUR
T1 - Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery
AU - Cho, Samuel K.
AU - Bridwell, Keith H.
AU - Lenke, Lawrence G.
AU - Cho, Woojin
AU - Zebala, Lukas P.
AU - Pahys, Joshua M.
AU - Kang, Matthew M.
AU - Yi, Jin Seok
AU - Baldus, Christine R.
PY - 2012/3/1
Y1 - 2012/3/1
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.
AB - 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.
KW - Clinical outcome
KW - complications
KW - primary surgery
KW - revision surgery
UR - http://www.scopus.com/inward/record.url?scp=84857910303&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84857910303&partnerID=8YFLogxK
U2 - 10.1097/BRS.0b013e31821f0126
DO - 10.1097/BRS.0b013e31821f0126
M3 - Article
C2 - 21540777
AN - SCOPUS:84857910303
SN - 0362-2436
VL - 37
SP - 393
EP - 401
JO - Spine
JF - Spine
IS - 5
ER -