TY - JOUR
T1 - Reoperation Rate After Posterior Spinal Fusion Varies Significantly by Lenke Type
AU - The Harms Study Group
AU - Buckland, Aaron
AU - Alanay, Ahmet
AU - Samdani, Amer
AU - Jain, Amit
AU - Lonner, Baron
AU - Roye, Benjamin
AU - Cho, Bob
AU - Yaszay, Burt
AU - Yilgor, Caglar
AU - Reilly, Chris
AU - Hoernschmeyer, Dan
AU - Hedequist, Daniel
AU - Sucato, Daniel
AU - Clements, David
AU - Miyanji, Firoz
AU - Shufflebarger, Harry
AU - Flynn, Jack
AU - Thiong, Jean Marc Mac
AU - Asghar, John
AU - Murphy, Josh
AU - Pahys, Joshua
AU - Harms, Juergen
AU - Bachmann, Keith
AU - Neal, Kevin
AU - Blakemore, Laurel
AU - Haber, Lawrence
AU - Lenke, Lawrence
AU - Karol, Lori
AU - Abel, Mark
AU - Erickson, Mark
AU - Glotzbecker, Michael
AU - Kelly, Michael
AU - Vitale, Michael
AU - Marks, Michelle
AU - Gupta, Munish
AU - Fletcher, Nicholas
AU - Larson, Noelle
AU - Cahill, Patrick
AU - Sponseller, Paul
AU - Gabos, Peter
AU - Newton, Peter
AU - Sturm, Peter
AU - Betz, Randal
AU - Parent, Stefan
AU - George, Stephen
AU - Hwang, Steven
AU - Shah, Suken A.
AU - Garg, Sumeet
AU - Errico, Tom
AU - Upasani, Vidyadhar
AU - Boufadel, Peter
AU - Badin, Daniel
AU - Samdani, Amer F.
AU - Sponseller, Paul D.
N1 - Publisher Copyright:
© 2024 The Authors.
PY - 2024/11/20
Y1 - 2024/11/20
N2 - Background: Lenke curve types can vary in their response to treatment. We explored potential differences in reoperation rates, causes, and risk factors among patients with different Lenke types who underwent posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Methods: We studied a multicenter database of patients with AIS who underwent index PSF at £21 years of age and had a minimum 2-year follow-up. Baseline and surgical characteristics were collected. Reoperation rates, causes, and risk factors were analyzed by Lenke type. Results: A total of 3,165 patients were included. The mean age was 14.6 years, and most patients were female (81%) and Caucasian (68%). The mean follow-up period was 4.4 years. A total of 138 patients (4.4%) underwent reoperation. The reoperation rate varied by Lenke type (p = 0.02): patients with type-5 curves had the highest reoperation rate (7.2%), and those with type-1 curves had the lowest (3.0%). The most common cause of reoperation was an instrumentation complication. The rate of reoperation due to an instrumentation complication varied by Lenke type (p < 0.01). Compared with patients with type-1 curves, those with type-5 curves had significantly higher rates of reoperation due to implant prominence (odds ratio [OR], 11.7; p = 0.03), loss of fixation (OR, 3.9; p = 0.01), or a broken rod (OR, 7.8; p = 0.02) and those with type-3 curves had a significantly higher rate of reoperation due to loss of fixation (OR, 4.37; p = 0.01). Independent risk factors for reoperation were a major curve magnitude of ‡60° in patients with type-5 curves (adjusted OR [aOR], 4.18; p = 0.04), a major curve correction of ‡40° in patients with type-5 curves (aOR, 3.6; p = 0.04), and a lowest instrumented vertebra (LIV) at or above L1 in patients with type-1 curves (aOR, 2.8; p = 0.02). Conclusions: The reoperation rate for patients with AIS who underwent PSF varied by Lenke type. Patients with type-5 curves had the highest reoperation rate, whereas patients with type-1 curves had the lowest. Patients with Lenke type-5 curves had a higher rate of reoperation due to instrumentation complications.
AB - Background: Lenke curve types can vary in their response to treatment. We explored potential differences in reoperation rates, causes, and risk factors among patients with different Lenke types who underwent posterior spinal fusion (PSF) for adolescent idiopathic scoliosis (AIS). Methods: We studied a multicenter database of patients with AIS who underwent index PSF at £21 years of age and had a minimum 2-year follow-up. Baseline and surgical characteristics were collected. Reoperation rates, causes, and risk factors were analyzed by Lenke type. Results: A total of 3,165 patients were included. The mean age was 14.6 years, and most patients were female (81%) and Caucasian (68%). The mean follow-up period was 4.4 years. A total of 138 patients (4.4%) underwent reoperation. The reoperation rate varied by Lenke type (p = 0.02): patients with type-5 curves had the highest reoperation rate (7.2%), and those with type-1 curves had the lowest (3.0%). The most common cause of reoperation was an instrumentation complication. The rate of reoperation due to an instrumentation complication varied by Lenke type (p < 0.01). Compared with patients with type-1 curves, those with type-5 curves had significantly higher rates of reoperation due to implant prominence (odds ratio [OR], 11.7; p = 0.03), loss of fixation (OR, 3.9; p = 0.01), or a broken rod (OR, 7.8; p = 0.02) and those with type-3 curves had a significantly higher rate of reoperation due to loss of fixation (OR, 4.37; p = 0.01). Independent risk factors for reoperation were a major curve magnitude of ‡60° in patients with type-5 curves (adjusted OR [aOR], 4.18; p = 0.04), a major curve correction of ‡40° in patients with type-5 curves (aOR, 3.6; p = 0.04), and a lowest instrumented vertebra (LIV) at or above L1 in patients with type-1 curves (aOR, 2.8; p = 0.02). Conclusions: The reoperation rate for patients with AIS who underwent PSF varied by Lenke type. Patients with type-5 curves had the highest reoperation rate, whereas patients with type-1 curves had the lowest. Patients with Lenke type-5 curves had a higher rate of reoperation due to instrumentation complications.
UR - http://www.scopus.com/inward/record.url?scp=85210977462&partnerID=8YFLogxK
U2 - 10.2106/JBJS.OA.23.00179
DO - 10.2106/JBJS.OA.23.00179
M3 - Article
C2 - 39569010
AN - SCOPUS:85210977462
SN - 2472-7245
VL - 9
JO - JBJS Open Access
JF - JBJS Open Access
IS - 4
M1 - e23.00179
ER -