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Long-term Morbidity in Patients After Surgical Correction of Adult Spinal Deformity: Results From a Cohort With Minimum 5-year Follow-up.

التفاصيل البيبلوغرافية
العنوان: Long-term Morbidity in Patients After Surgical Correction of Adult Spinal Deformity: Results From a Cohort With Minimum 5-year Follow-up.
المؤلفون: Imbo B; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Williamson T; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Joujon-Roche R; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Krol O; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Tretiakov P; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Ahmad S; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Bennett-Caso C; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Schoenfeld AJ; Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA., Dinizo M; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., De La Garza-Ramos R; Department of Neurosurgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY., Janjua MB; Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX., Vira S; Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX., Ihejirika-Lomedico R; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Raman T; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., O'Connell B; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Maglaras C; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY., Paulino C; Department of Orthopaedic Surgery, SUNY Downstate Medical Center, New York, NY., Diebo B; Department of Orthopaedic Surgery, SUNY Downstate Medical Center, New York, NY., Lafage R; Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY., Lafage V; Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY., Passias PG; Division of Spinal Surgery, Departments of Orthopaedic and Neurosurgery, NYU Langone Medical Center, NY Spine Institute, New York, NY.
المصدر: Spine [Spine (Phila Pa 1976)] 2023 Aug 01; Vol. 48 (15), pp. 1089-1094. Date of Electronic Publication: 2023 Apr 11.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7610646 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1159 (Electronic) Linking ISSN: 03622436 NLM ISO Abbreviation: Spine (Phila Pa 1976) Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Hagerstown, Md., Medical Dept., Harper & Row.
مواضيع طبية MeSH: Kyphosis*/surgery , Kyphosis*/etiology , Spinal Fusion*/adverse effects , Spinal Fusion*/methods, Humans ; Adult ; Male ; Female ; Middle Aged ; Follow-Up Studies ; Retrospective Studies ; Quality of Life ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Incidence
مستخلص: Study Design: Retrospective.
Objective: The objective of this study is to describe the rate of postoperative morbidity before and after two-year (2Y) follow-up for patients undergoing surgical correction of adult spinal deformity (ASD).
Summary of Background Data: Advances in modern surgical techniques for deformity surgery have shown promising short-term clinical results. However, the permanence of radiographic correction, mechanical complications, and revision surgery in ASD surgery remains a clinical challenge. Little information exists on the incidence of long-term morbidity beyond the acute postoperative window.
Methods: ASD patients with complete baseline and five-year (5Y) health-related quality of life and radiographic data were included. The rates of adverse events, including proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and reoperations up to 5Y were documented. Primary and revision surgeries were compared. We used logistic regression analysis to adjust for demographic and surgical confounders.
Results: Of 118 patients eligible for 5Y follow-up, 99(83.9%) had complete follow-up data. The majority were female (83%), mean age 54.1 years and 10.4 levels fused and 14 undergoing three-column osteotomy. Thirty-three patients had a prior fusion and 66 were primary cases. By 5Y postop, the cohort had an adverse event rate of 70.7% with 25 (25.3%) sustaining a major complication and 26 (26.3%) receiving reoperation. Thirty-eight (38.4%) developed PJK by 5Y and 3 (4.0%) developed PJF. The cohort had a significantly higher rate of complications (63.6% vs. 19.2%), PJK (34.3% vs. 4.0%), and reoperations (21.2% vs. 5.1%) before 2Y, all P <0.01. The most common complications beyond 2Y were mechanical complications.
Conclusions: Although the incidence of adverse events was high before 2Y, there was a substantial reduction in longer follow-up indicating complications after 2Y are less common. Complications beyond 2Y consisted mostly of mechanical issues.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
References: Smith JS, Shaffrey CI, Lafage V, et al. Comparison of best versus worst clinical outcomes for adult spinal deformity surgery: a retrospective review of a prospectively collected, multicenter database with 2-year follow-up. J Neurosurg Spine. 2015;23:1–11.
Smith JS, Shaffrey CI, Ames CP, Lenke LG. Treatment of adult thoracolumbar spinal deformity: past, present, and future. J Neurosurg Spine. 2019;30:551–67.
Riley MS, Bridwell KH, Lenke LG, Dalton J, Kelly MP. Health-related quality of life outcomes in complex adult spinal deformity surgery. J Neurosurg Spine. 2018;28:194–200.
Krieg SM, Vajkoczy P, Eicker SO, et al. Operative behandlung adulter spinaler Deformitäten. Nervenarzt. 2018;89:648–657.
Wick JB, Le H v, Lafage R, et al. Assessment of adult spinal deformity complication timing and impact on 2-year outcomes using a comprehensive adult spinal deformity classification system. Spine (Phila Pa 1976). 2022;47:445–54.
Passias PG, Bortz CA, Lafage V, et al. Durability of satisfactory functional outcomes following surgical adult spinal deformity correction: a 3-year survivorship analysis. Oper Neurosurg (Hagerstown). 2020;18:118–25.
Soroceanu A, Burton DC, Oren JH, et al. Medical complications after adult spinal deformity surgery: incidence, risk factors, and clinical impact. Spine (Phila Pa 1976). 2016;18:345–52.
Yadla S, Maltenfort MG, Ratliff JK, Harrop JS. Adult scoliosis surgery outcomes: a systematic review. Neurosurg Focus. 2010;28:E3.
Barone G, Giudici F, Martinelli N, et al. Mechanical complications in adult spine deformity surgery: retrospective evaluation of incidence, clinical impact and risk factors in a single-center large series. J Clin Med. 2021;10:1811.
Soroceanu A, Diebo BG, Burton D, et al. Radiographical and implant-related complications in adult spinal deformity surgery: incidence, patient risk factors, and impact on health-related ouality of life. Spine (Phila Pa 1976). 2015;40:1414–21.
Klineberg EO, Passias PG, Poorman GW, et al. Classifying complications: assessing adult spinal deformity 2-year surgical outcomes. Glob Spine J. 2020;10:896–907.
Soroceanu A, Burton DC, Diebo BG, et al. Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery. J Neurosurg Spine. 2015;23:1–9.
Yagi M, Hosogane N, Fujita N, et al. Surgical risk stratification based on preoperative risk factors in adult spinal deformity. Spine J. 2019;19:816–26.
Scheer JK, Daniels AH, Smith JS, et al. Development of a preoperative predictive model for major complications following adult spinal deformity surgery. J Neurosurg Spine. 2017;26:1–8.
Passias PG, Moattari K, Pierce KE, et al. Performance of the Modified Adult Spinal Deformity Frailty Index (mASD-FI) in preoperative risk assessment. Spine (Phila Pa 1976). 2022;47:1463–9.
Passias PG, Passfall L, Williamson TK, et al. The clinical impact of failing to achieve ideal proportional realignment in adult spinal deformity patients. Spine (Phila Pa 1976). 2022;47:995–1002.
Champain S, Benchikh K, Nogier A, Mazel C, de Guise J, Skalli W. Validation of new clinical quantitative analysis software applicable in spine orthopaedic studies. Eur Spine J. 2006;15:982–91.
Rillardon L, Levassor N, Guigui P, et al. Validation of a tool to measure pelvic and spinal parameters of sagittal balance. Rev Chir Orthop Reparatrice Appar Mot. 2003;89:218–227.
O’Brien MF, Kuklo TR, Blanke KM, Lenke LG. Spinal Deformity Study Group Radiographic Measurement Manual . Medtronic Sofamor Danek; 2005. Accessed March 20, 2022. http://www.oref.org/docs/default-source/default-document-library/sdsg-radiographic-measuremnt-manual.pdf?sfvrsn=2.
Lafage R, Schwab FJ, Bess S, et al. Redefining radiographic thresholds for junctional kyphosis pathologies. J Spine. 2015;15:S216.
Li XJ, Lenke LG, Jin L, et al. Surgeon-specific risk stratification model for early complications after complex adult spinal deformity surgery. Spine Deform. 2020;8:97–104.
Qiao J, Xiao L, Sun X, et al. Three column osteotomy for adult spine deformity: comparison of outcomes and complications between kyphosis and kyphoscoliosis. Br J Neurosurg. 2018;32:32–36.
Lenke LG, Fehlings MG, Shaffrey CI, Cheung KM, Carreon LY. Prospective, multicenter assessment of acute neurologic complications following complex adult spinal deformity surgery: the Scoli-Risk-1 Trial. J Spine. 2013;13:S67.
Rabinovich EP, Buell TJ, Wang TR, Shaffrey CI, Smith JS. Reduced occurrence of primary rod fracture after adult spinal deformity surgery with accessory supplemental rods: retrospective analysis of 114 patients with minimum 2-year follow-up. J Neurosurg Spine. 2021;35:504–15.
Verma R, Lafage R, Scheer J, et al. Improvement in back and leg pain and disability following adult spinal deformity surgery. Spine (Phila Pa 1976). 2019;44:263–9.
Scheer JK, Smith JS, Clark AJ, et al. Comprehensive study of back and leg pain improvements after adult spinal deformity surgery: analysis of 421 patients with 2-year follow-up and of the impact of the surgery on treatment satisfaction. J Neurosurg Spine. 2015;22:1–14.
Auerbach JD, Lenke LG, Bridwell KH, et al. Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine (Phila Pa 1976). 2012;37:1198–210.
Qiao J, Xiao L, Sun X, et al. Vertebral subluxation during three-column osteotomy in surgical correction of adult spine deformity: incidence, risk factors, and complications. Eur Spine J. 2018;27:630–5.
Smith JS, Shaffrey CI, Klineberg E, et al. Complication rates associated with 3-column osteotomy in 82 adult spinal deformity patients: retrospective review of a prospectively collected multicenter consecutive series with 2-year follow-up. J Neurosurg Spine. 2017;27:444–57.
Paul JC, Lonner BS, Goz V, et al. Complication rates are reduced for revision adult spine deformity surgery among high-volume hospitals and surgeons. Spine J. 2015;15:1963–72.
Sethi RK, Wright AK, Nemani VM, et al. Team approach: safety and value in the practice of complex adult spinal surgery. JBJS Rev. 2020;8:e0145.
تواريخ الأحداث: Date Created: 20230411 Date Completed: 20230719 Latest Revision: 20230719
رمز التحديث: 20231215
DOI: 10.1097/BRS.0000000000004681
PMID: 37040468
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1159
DOI:10.1097/BRS.0000000000004681