TY - JOUR
T1 - 1- vs. 2-year follow-up after posterior spinal fusion for AIS
T2 - what additional information is gained?
AU - Harms Study Group
AU - Shaw, K. Aaron
AU - Orland, Keith
AU - Bastrom, Tracey P.
AU - Newton, Peter O.
AU - Buckland, Aaron
AU - Samdani, Amer
AU - Pahys, Joshua
AU - Hwang, Steven
AU - Jain, Amit
AU - Sponseller, Paul
AU - Lonner, Baron
AU - Roye, Benjamin
AU - Lenke, Larry
AU - Vitale, Michael
AU - Lehman, Ron
AU - Yaszay, Burt
AU - Upasani, Vidyadhar
AU - Reilly, Chris
AU - Miyanji, Firoz
AU - Hedequist, Daniel
AU - Glotzbecker, Michael
AU - Sucato, Daniel
AU - Clements, David
AU - Shufflebarger, Harry
AU - George, Stephen
AU - Errico, Tom
AU - Flynn, Jack
AU - Cahill, Patrick
AU - Mac-Thiong, Jean Marc
AU - Parent, Stefan
AU - Harms, Juergen
AU - Bachmann, Keith
AU - Abel, Mark
AU - Kelly, Michael
AU - Gupta, Munish
AU - Marks, Michelle
AU - Fletcher, Nicholas
AU - Gabos, Peter
AU - Shah, Suken
AU - Sturm, Peter
AU - Betz, Randal
AU - Fletcher, Nicholas D.
N1 - Funding Information:
Harms Study Group Investigators: Aaron Buckland, MD: New York University. Amer Samdani, MD; Joshua Pahys, MD; and Steven Hwang, MD: Shriners Hospitals for Children—Philadelphia. Amit Jain, MD; and Paul Sponseller, MD: Johns Hopkins Hospital. Baron Lonner, MD: Mount Sinai Hospital. Benjamin Roye, MD; Larry Lenke, MD; Michael Vitale, MD; and Ron Lehman, MD: Columbia University. Burt Yaszay, MD; Peter Newton, MD; and Vidyadhar Upasani, MD: Rady Children's Hospital. Chris Reilly, MD; and Firoz Miyanji, MD: BC Children's Hospital. Daniel Hedequist, MD; and Michael Glotzbecker, MD: Boston Children's Hospital. Daniel Sucato, MD: Texas Scottish Rite Hospital. David Clements, MD: Cooper Bone & Joint Institute New Jersey. Harry Shufflebarger, MD; Stephen George, MD; and Tom Errico, MD: Nicklaus Children's Hospital. Jack Flynn, MD; and Patrick Cahill, MD: Children's Hospital of Philadelphia. Jahangir Asghar, MD: Cantor Spine Institute. Jean Marc Mac-Thiong, MD; and Stefan Parent, MD: CHU Sainte-Justine. Juergen Harms, MD: ETHIANUM Klinik, Heidelberg, Germany. Keith Bachmann, MD; and Mark Abel, MD: University of Virginia. Michael Kelly, MD; and Munish Gupta, MD: Washington University. Michelle Marks, PT, MA: Setting Scoliosis Straight Foundation. Nicholas Fletcher, MD: Emory University. Peter Gabos, MD; and Suken Shah, MD: Nemours/Alfred I. duPont Hospital for Children. Peter Sturm, MD: Cincinnati Children's Hospital. Randal Betz, MD: Institute for Spine & Scoliosis.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Scoliosis Research Society.
PY - 2022/11
Y1 - 2022/11
N2 - Purpose: Traditionally, 2-year follow-up data have been the established standard for reporting clinical outcomes following spinal deformity surgery. However, previous studies indicate that 2-year follow-up does not represent long-term outcomes. Currently, there is no clear data that demonstrate a difference in outcomes between the 1 and 2 years postoperative time-periods following posterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS). Methods: A multi-center, prospective database was queried for AIS patients treated with PSF. Clinical outcome scores, assessed by SRS-22, coronal and sagittal radiographic parameters were assessed at time periods: 6 months, 1 year, and 2 years post operatively. Complications and reoperation rates were also assessed. Statistical analysis compared outcomes variables across time-points to assess for significant differences. Results: 694 patients (82.6% female, mean age at surgery 14.9 ± 2.13 years) were identified. Between post-operative year 1 and 2, significant difference in SRS-22 domain scores were present for function domain (4.5 vs. 4.6; p < 0.001), mental health domain (4.3 vs. 4.2; p < 0.001), and total domain score (4.4 vs. 4.4; p = 0.03) but were below the minimal clinically important difference threshold. New complication development was significantly higher within the first year following surgery than the 1–2 year follow-up period (p < 0.001) with greater complication severity within the 0–1 year follow-up period (P = 0.03). Conclusion: There are no clinically important changes in SRS-22 domain scores between 1 and 2 years following PSF for AIS, with higher complications in the first year following PSF. Two-year follow-up data provide little added clinical information while under-estimating the cumulative complication and reoperation rates at long-term follow-up.
AB - Purpose: Traditionally, 2-year follow-up data have been the established standard for reporting clinical outcomes following spinal deformity surgery. However, previous studies indicate that 2-year follow-up does not represent long-term outcomes. Currently, there is no clear data that demonstrate a difference in outcomes between the 1 and 2 years postoperative time-periods following posterior spinal fusions (PSF) for adolescent idiopathic scoliosis (AIS). Methods: A multi-center, prospective database was queried for AIS patients treated with PSF. Clinical outcome scores, assessed by SRS-22, coronal and sagittal radiographic parameters were assessed at time periods: 6 months, 1 year, and 2 years post operatively. Complications and reoperation rates were also assessed. Statistical analysis compared outcomes variables across time-points to assess for significant differences. Results: 694 patients (82.6% female, mean age at surgery 14.9 ± 2.13 years) were identified. Between post-operative year 1 and 2, significant difference in SRS-22 domain scores were present for function domain (4.5 vs. 4.6; p < 0.001), mental health domain (4.3 vs. 4.2; p < 0.001), and total domain score (4.4 vs. 4.4; p = 0.03) but were below the minimal clinically important difference threshold. New complication development was significantly higher within the first year following surgery than the 1–2 year follow-up period (p < 0.001) with greater complication severity within the 0–1 year follow-up period (P = 0.03). Conclusion: There are no clinically important changes in SRS-22 domain scores between 1 and 2 years following PSF for AIS, with higher complications in the first year following PSF. Two-year follow-up data provide little added clinical information while under-estimating the cumulative complication and reoperation rates at long-term follow-up.
KW - Adolescent idiopathic scoliosis
KW - Complications
KW - Follow-up
KW - Posterior spinal fusion
KW - Quality of life
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U2 - 10.1007/s43390-022-00555-z
DO - 10.1007/s43390-022-00555-z
M3 - Article
C2 - 35869332
AN - SCOPUS:85134544294
SN - 2212-134X
VL - 10
SP - 1359
EP - 1366
JO - Spine deformity
JF - Spine deformity
IS - 6
ER -