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why would you need a Revision surgery?

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  • #16
    Originally posted by hdugger View Post
    Isn't that the one where they had a large number of patients between 18 and 20? I was recommending the UCSF one because it had more mature patients.

    Do we have the full papers somewhere so that we could look at the age breakdown?
    I downloaded both papers. The St. Louis paper states:

    "Patient ages were broken up into 10-year blocks for comparison. There were 257 (40%) patients aged 18-29 years, 84 (13.1%) aged 30-39 years, 113 (17.6%) aged 40-49, 110 (17.1%) aged 50-59 years, and 79 (12.3%) aged 60 or greater. Comparing patients who had reoperation with those that did not, there were significantly fewer reoperations for the 18-29 year old group compared with the other 4 groups.

    I've attached an Excel file with the data in chart format.

    The UCSF paper doesn't have the data broken down by age, but the average age was 49 years.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

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    • #17
      OOPS, can't upload Excel files.
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #18
        Thanks for all of the information that you have presented me with

        Melissa

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        • #19
          Yeah, that does make it hard to compare. The only figure you can compare is the average age. It's roughly 37 for the Lenke study, so 12 or so years younger on average.

          But, even knocking out those younger patients, Lenke's group just has a much much lower rate of revision compared to the UCSF group. I don't see the numbers for over 60, but age 50 to 59 has a reoperation rate below 10%. And, again, that's including people with harrington rods.

          I really would love to hear these two groups of surgeons discussing their results. It seems like something more than just different patient populations is going on.

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          • #20
            Meaning of "mortality" in this study

            Ignorant. I hope, question...

            When the authors speak of "mortality" in this study about revision rates, are they referring to actual deaths among the cohort, or does it refer to death of the (successful) implant or some other sense of the word mortality.

            I know this surgery is no walk in the park, but surely (?) it's not possible that a quarter of the patients have died by the end of three years. Right? Right??

            If so I'd definitely like to know. It would put quite a different slant on things for me.

            But before I say more, let me check out my interpretation. I already see I grossly misinterpreted the stats on revision rates in the Lenke study (and to think I once studied statistics in college! I won't even admit what I did wrong. )

            Thanks all!

            Amanda

            http://www.ncbi.nlm.nih.gov/pubmed/1...ystem2.PEntrez
            Last edited by Back-out; 04-28-2010, 02:56 AM. Reason: forgot to link study
            Not all diagnosed (still having tests and consults) but so far:
            Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
            main curve L Cobb 60, compensating T curve ~ 30
            Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

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            • #21
              The abstract uses the term (under objective) survivorship of primary fusion, so I believe that mortality refers to fusion failure, not the death of the person.
              1966 fusion in Buffalo of 11 thoracic vertebrae, with Harrington rod

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              • #22
                Thanks, Julie! You sound knowledgeable, but just to double check I'd like to put out another feeler. I'd rather feel silly than live with anxiety. I'm a great believer in reality checks.

                Why worry about nothing? OTOH why NOT worry about "something" if it's there (however doubtful), especially, as it's all part of the information gathering I'm engaged in! The language certainly IS suggestive, whether or not it's used outside of the normal lay meaning.

                So. how do others read this article in the key word I'm hung up on?
                Not all diagnosed (still having tests and consults) but so far:
                Ehler-Danlos (hyper-mobility) syndrome, 69 - somehow,
                main curve L Cobb 60, compensating T curve ~ 30
                Flat back, marked lumbar kyphosis (grade?) Spondilolisthesis - everyone gives this a different grade too. Cervical stenosis op'd 3-07, minimally invasive

                Comment

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