Repeat surgical interventions following "defi nitive" instrumentation and fusion for idiopathic scoliosis

Study Design. A retrospective case series. Objective. To identify the overall reoperation rate and factors contributing to reoperation in a recent 5-year cohort of patients (2003-2007) undergoing spinal deformity surgery. These patients were compared with a previously published 15-year cohort of consecutive patients (1988-2002) from the same institution to assess for any signifi cant differences in reoperation rates. Summary of Background Data. In a previously published report from this institution, the reoperation rate for patients with idiopathic scoliosis treated during a 15-year period (1988-2002) was 12.9%. That group was predominantly treated with fi rst-generation TSRH (Medtronic, Memphis, TN) implants and CD implants. Lower profi le, more rigid implant systems are now used along with refi ned techniques for correction of scoliosis deformity. We hypothesized that these factors would lead to lower rates of reoperation. Methods. The medical records of 452 consecutive patients (older than 9 yr) surgically treated for idiopathic scoliosis at one institution during 5 years (2003-2007) were reviewed to identify those who required reoperation. Results. The reoperation rate for this cohort was 7.5% (34 of 452 patients). Compared with the prior cohort, signifi cant decreases were noted with regard to total reoperation rate as well as reoperation due to infection and pseudarthrosis. Trends were noted toward decreased rates of reoperation due to prominent implants, dislodged implants, and implant proximity to vital structures. Within the newer cohort, a trend toward decreased reoperation rate was also noted for lower profi le implant systems compared with fi rst-generation TSRH implants Conclusion. With the evolution of newer lower profi le segmental implant systems that provide more rigid fi xation and with the advancements in techniques for deformity correction, the repeat surgical intervention rate for idiopathic scoliosis has decreased.