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Tag: adult scoliosis|article link|clinical outcome|comparative analysis|Scoliosis

Comparative Analysis of Clinical Outcome and Complications in Primary vs. Revision Adult Scoliosis Surgery.

By wp_zaman

Comparative Analysis of Clinical Outcome and Complications in Primary vs. Revision Adult Scoliosis Surgery.

Spine (Phila Pa 1976). 2011 May 2;

Authors: Cho SK, Bridwell KH, Lenke LG, Cho W, Zebala LP, Pahys JM, Kang MM, Yi JS, Baldus CR

ABSTRACT: Study Design: A retrospective case comparison studyObjective: We compared clinical outcome and complications in adult patients who underwent primary (P) vs. revision (R) scoliosis surgery.Summary of Background Data: There is a paucity of data comparing P vs. R adult scoliosis patients with respect to their complication rates and clinical outcome.Methods: Assessment of 250 consecutive adult patients who underwent P vs. R surgery for idiopathic or de novo scoliosis between 2002 and 2007 with a minimum 2-year follow-up was performed.Results: There were 126 patients in P group and 124 in R group. Mean age at surgery (P = 51.2 vs. R = 51.6 years, p = 0.79), length of follow-up (P = 3.6 vs. R = 3.6 years, p = 0.94), comorbidities (p = 0.43), and smoking status (p = 0.98) were similar between the 2 groups. Body mass index (P = 25.5 vs. R = 27.4 kg/m, p = 0.01), number of final instrumented levels (P = 10.5 vs. R 12.1 levels, p = 0.00), fusion to the sacrum (P = 61.0% vs. R = 87.1%, p = 0.00), osteotomy (P = 14.3% vs. R = 54.9%, p = 0.00), length of surgery (P = 6.5 vs. R = 8.2 hrs, p = 0.00), and estimated blood loss (P = 1072.1 vs. R = 1401.3 ml, p = 0.05) were different. Primary patients had significantly lower overall complications than revision patients (P = 45.2% vs. R = 58.2%, p = 0.042). Primary patients reported significantly higher preoperative and final clinical outcome measures in function, pain, and subscore SRS domains and ODI compared to revision patients (all p<0.05). Patients over 60 years of age, however, reported similar SRS and ODI scores between the 2 groups. The extent of surgical benefit patients received, i.e., final minus preoperative score, was similar in all categories between the 2 groups.Conclusion: Adult patients undergoing primary scoliosis surgery had significantly lower overall complications compared to revision patients. Primary patients reported higher preoperative and final clinical outcome measures than revision patients, although this difference disappeared in older patients. The benefit of surgery was similar between the 2 groups.

PMID: 21540777 [PubMed – as supplied by publisher]