Repeat surgical interventions following “definitive” instrumentation and fusion for idiopathic scoliosis: a 30-year update

Adam A. Jamnik, Anne Marie Datcu, Emily Lachmann, Sahiti D. Patibandla, David Thornberg, Chan hee Jo, William Z. Morris, Brandon Ramo, Megan Johnson

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose: Although spinal fusion (SF) is considered “definitive” treatment in juvenile/adolescent idiopathic scoliosis (JIS/AIS), complications requiring reoperation continue to occur. The purpose of this study was to characterize the evolving rates of reoperation following SF in JIS/AIS. Methods: Single-center retrospective review of patients who underwent SF for JIS/AIS as their index surgical treatment between 2013 and 2019. Patient data were collected to identify complications requiring reoperation and factors associated with reoperation. Complication rates from 2013 to 2019 were compared to patients from 1988 to 2012 at the same institution. Results: This study analyzed 934 patients (81.7% female, mean age at surgery 14.5 ± 2.1). Thirty-eight patients (4.1%) required a total of 47 reoperations, a > 50% decrease in overall complication rate from the 2008–2012 population (4.1% vs 9.6%, respectively, p < 0.001). The decrease stemmed mainly from decreases in rates of infection (1.1% vs 4.1%, p < 0.001) and symptomatic implants (0.4% vs 2.1%, p = 0.004). There were, however, non-significant increases in implant failures (0.6% vs 0.2%, p = 0.4367) and pseudoarthrosis (1.0% vs 0.4%, p = 0.5202). Both of these complications were associated with patients with a higher mean weight (implant failure: 70.4 kg ± 21.1 vs 56.1 kg ± 14.9, p = 0.002; pseudoarthrosis: 85.8 kg ± 27.9 vs 55.9 ± 14.5, p = 0.001). Conclusions: Reoperation following SF for JIS/AIS has decreased over the past 7 years when compared to 25 years of historical controls. The changing landscape of reoperation demands further research into the risk factors for those reoperations that have become more common.

Original languageEnglish (US)
Pages (from-to)99-107
Number of pages9
JournalSpine deformity
Volume12
Issue number1
DOIs
StatePublished - Jan 2024

Keywords

  • Adolescent idiopathic scoliosis
  • Complications
  • Definitive fusion
  • Juvenile idiopathic scoliosis
  • Reoperation

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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