The Fate of the Adult Revision Spinal Deformity Patient: A Single Institution Experience
Kelly, Michael P.; Lenke, Lawrence G.; Bridwell, Keith H.; Agarwal, Rashmi; Godzik, Jakub; Koester, Linda
Spine., POST ACCEPTANCE, 11 June 2013
Abstract:
Study Design: Retrospective case series.
Objective: The aim of this study was to determine the repeat revision rates for all revision SD surgeries performed at a single center and to investigate the changes in measures of HRQL in these patients.
Summary of Background Data: Reported revision rates for primary adult spinal fusion surgeries have ranged from 9% to 45%, but to our knowledge, the repeat revision rate following revision spinal deformity (SD) surgery has not been reported. The reported improvements in health-related quality of life (HRQL) measures following revision SD surgery have also been quite modest.
Methods: 455 consecutive adult revision SD surgeries (1995-2008) were identified and the records were reviewed to determine the reason for and timing to any additional operation(s). SRS Outcomes scores were recorded at the first visit and at planned followup visits.
Results: 94/455 patients underwent further surgeries for a repeat revision rate of 21%. 2-year followup was available for 74 (78%) of these patients (mean followup, 6.0 years, range 2.4-12.6, gender: F = 61, M = 13; mean age 53 years, range 21-78). The most common causes of repeat revision surgery were pseudarthrosis (N = 23, 31%), implant prominence/pain (N = 15, 20%), adjacent segment disease (N = 14, 19%), and infection (N = 10, 14%). Twenty five (27%) patients underwent more than one revision procedure. SRS Outcomes scores were available for 50 (68%) patients, at an average followup of 4.9 years (range 2-11.4). The mean improvements in the SRS outcomes measures were Pain: 0.74 (p<0.001), Self-Image: 0.8 (p<0.001), Function: 0.5 (p<0.001), Satisfaction: 1.2 (p<0.001) and Mental Health: 0.3 (p = 0.012).
Conclusion: The rate of repeat revision following revision spinal deformity surgery was 21%, most commonly due to pseudarthrosis, adjacent segment disease, infection and implant prominence/pain. However, significant improvements in SRS outcome scores were still observed in those patients requiring additional revision procedures.
(C) 2013 Lippincott Williams & Wilkins, Inc.
Kelly, Michael P.; Lenke, Lawrence G.; Bridwell, Keith H.; Agarwal, Rashmi; Godzik, Jakub; Koester, Linda
Spine., POST ACCEPTANCE, 11 June 2013
Abstract:
Study Design: Retrospective case series.
Objective: The aim of this study was to determine the repeat revision rates for all revision SD surgeries performed at a single center and to investigate the changes in measures of HRQL in these patients.
Summary of Background Data: Reported revision rates for primary adult spinal fusion surgeries have ranged from 9% to 45%, but to our knowledge, the repeat revision rate following revision spinal deformity (SD) surgery has not been reported. The reported improvements in health-related quality of life (HRQL) measures following revision SD surgery have also been quite modest.
Methods: 455 consecutive adult revision SD surgeries (1995-2008) were identified and the records were reviewed to determine the reason for and timing to any additional operation(s). SRS Outcomes scores were recorded at the first visit and at planned followup visits.
Results: 94/455 patients underwent further surgeries for a repeat revision rate of 21%. 2-year followup was available for 74 (78%) of these patients (mean followup, 6.0 years, range 2.4-12.6, gender: F = 61, M = 13; mean age 53 years, range 21-78). The most common causes of repeat revision surgery were pseudarthrosis (N = 23, 31%), implant prominence/pain (N = 15, 20%), adjacent segment disease (N = 14, 19%), and infection (N = 10, 14%). Twenty five (27%) patients underwent more than one revision procedure. SRS Outcomes scores were available for 50 (68%) patients, at an average followup of 4.9 years (range 2-11.4). The mean improvements in the SRS outcomes measures were Pain: 0.74 (p<0.001), Self-Image: 0.8 (p<0.001), Function: 0.5 (p<0.001), Satisfaction: 1.2 (p<0.001) and Mental Health: 0.3 (p = 0.012).
Conclusion: The rate of repeat revision following revision spinal deformity surgery was 21%, most commonly due to pseudarthrosis, adjacent segment disease, infection and implant prominence/pain. However, significant improvements in SRS outcome scores were still observed in those patients requiring additional revision procedures.
(C) 2013 Lippincott Williams & Wilkins, Inc.
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