Long-term Morbidity in Patients After Surgical Correction of Adult Spinal Deformity Results From a Cohort With Minimum 5-year Follow-up

被引：6

作者：

Imbo, Bailey ^{[1
,2
]}

Williamson, Tyler ^{[1
,2
]}

Joujon-Roche, Rachel ^{[1
,2
]}

Krol, Oscar ^{[1
,2
]}

Tretiakov, Peter ^{[1
,2
]}

Ahmad, Salman ^{[1
,2
]}

Bennett-Caso, Claudia ^{[1
,2
]}

Schoenfeld, Andrew J. ^{[3
]}

Dinizo, Michael ^{[1
,2
]}

de la Garza-Ramos, Rafael ^{[4
]}

Janjua, M. Burhan ^{[5
]}

Vira, Shaleen ^{[6
]}

Ihejirika-Lomedico, Rivka ^{[1
,2
]}

Raman, Tina ^{[1
,2
]}

O'Connell, Brooke ^{[1
,2
]}

Maglaras, Constance ^{[1
,2
]}

Paulino, Carl ^{[7
]}

Diebo, Bassel ^{[7
]}

Lafage, Renaud ^{[8
]}

Lafage, Virginie ^{[9
]}

Passias, Peter G. ^{[1
,2
,10
,11
]}

机构：

[1] NY Spine Inst, Dept Orthopaed, Div Spinal Surg, New York, NY USA

[2] NY Spine Inst, NYU Langone Med Ctr, Dept Neurosurg, New York, NY USA

[3] Harvard Med Sch, Brigham & Womens Hosp, Dept Orthopaed Surg, Boston, MA USA

[4] Albert Einstein Coll Med, Montefiore Med Ctr, Dept Neurosurg, Bronx, NY USA

[5] Washington Univ, Dept Orthopaed Surg, St Louis, MO USA

[6] UT Southwestern Med Ctr, Dept Orthopaed Surg, Dallas, TX USA

[7] SUNY Downstate Med Ctr, Dept Orthopaed Surg, New York, NY USA

[8] Hosp Special Surg, Dept Orthoped Surg, New York, NY USA

[9] Lenox Hill Hosp, Dept Orthoped Surg, Northwell Hlth, New York, NY USA

[10] Orthoped Hosp, Div Spinal Surg, Dept Orthopaed, NYU Sch Med, 301 East 17th St, New York, NY 10003 USA

[11] Orthoped Hosp, New York Spine Inst, NYU Langone Med Ctr, NYU Sch Med, 301 East 17th St, New York, NY 10003 USA

来源：

SPINE | 2023年 / 48卷 / 15期

关键词：

5-year morbidity; adult spinal deformity; complications; reoperations; 3-COLUMN OSTEOTOMY; MAJOR COMPLICATIONS; OUTCOMES; VALIDATION; IMPACT; RATES; MODEL;

D O I：

10.1097/BRS.0000000000004681

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Study Design.Retrospective. Objective.The objective of this study is to describe the rate of postoperative morbidity before and after two-year (2Y) follow-up for patients undergoing surgical correction of adult spinal deformity (ASD). Summary of Background Data.Advances in modern surgical techniques for deformity surgery have shown promising short-term clinical results. However, the permanence of radiographic correction, mechanical complications, and revision surgery in ASD surgery remains a clinical challenge. Little information exists on the incidence of long-term morbidity beyond the acute postoperative window. Methods.ASD patients with complete baseline and five-year (5Y) health-related quality of life and radiographic data were included. The rates of adverse events, including proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and reoperations up to 5Y were documented. Primary and revision surgeries were compared. We used logistic regression analysis to adjust for demographic and surgical confounders. Results.Of 118 patients eligible for 5Y follow-up, 99(83.9%) had complete follow-up data. The majority were female (83%), mean age 54.1 years and 10.4 levels fused and 14 undergoing three-column osteotomy. Thirty-three patients had a prior fusion and 66 were primary cases. By 5Y postop, the cohort had an adverse event rate of 70.7% with 25 (25.3%) sustaining a major complication and 26 (26.3%) receiving reoperation. Thirty-eight (38.4%) developed PJK by 5Y and 3 (4.0%) developed PJF. The cohort had a significantly higher rate of complications (63.6% vs. 19.2%), PJK (34.3% vs. 4.0%), and reoperations (21.2% vs. 5.1%) before 2Y, all PConclusions.Although the incidence of adverse events was high before 2Y, there was a substantial reduction in longer follow-up indicating complications after 2Y are less common. Complications beyond 2Y consisted mostly of mechanical issues.

引用

页码：1089 / 1094

页数：6

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