TY - JOUR
T1 - Revision surgery after primary spine fusion for idiopathic scoliosis
AU - Luhmann, Scott J.
AU - Lenke, Lawrence G.
AU - Bridwell, Keith H.
AU - Schootman, Mario
PY - 2009/9
Y1 - 2009/9
N2 - STUDY DESIGN. Retrospective case series. OBJECTIVE. The objective of this study was to review the overall prevalence of, and indications for, reoperations after the index spine fusion for idiopathic scoliosis at our center. SUMMARY OF BACKGROUND DATA. Spine fusions for idiopathic scoliosis are expected to be the final therapeutic intervention in management. In a recent publication in 2006, reoperations after index spine fusion for idiopathic scoliosis were reported in 12.9% of patients at a single institution (n = 1046). METHODS. A spinal deformity database search at our center identified all primary anterior, posterior, and circumferential spinal fusions performed for idiopathic scoliosis (1985-2003). A total of 1057 patients were identified whose mean age was 14.4 years (7-22 years) with minimum 2 year follow-up after index surgery. Study cohort consisted patients who underwent reoperation for any reason after index fusion procedure. RESULTS. Of the 1057 spinal fusions for idiopathic scoliosis, 41 (3.9%) underwent reoperation. Primary surgeries were: 11 anterior spinal fusions, 25 posterior spinal fusions, and 5 circumferential spinal fusions. Mean follow-up was 5.7 years (2-10.8). Forty-seven additional procedures were performed during 46 reoperations at an average of 26 months after index procedure (1 week-73 months). Of the 47 reoperations, 20 (43%) were revision spinal fusions (for pseudarthroses, uninstrumented curve progression or junctional kyphosis), 16 (34%) because of infections (5 acute, 11 chronic), 7 (15%) for implant removals due to pain and/or prominence (4 complete, 3 partial), 2 (4%) were revision of loosened implants, and 2 (4%) were elective thoracoplasties. CONCLUSION. This study documented a 3.9% overall reoperation rate at our medical center, a 3-fold lower reoperation rate than the previously reported 12.9%. The most common reoperations were for infections (34%), pseudarthroses (26%), and postoperative curve progression of the adjacent unfused spine (17%).
AB - STUDY DESIGN. Retrospective case series. OBJECTIVE. The objective of this study was to review the overall prevalence of, and indications for, reoperations after the index spine fusion for idiopathic scoliosis at our center. SUMMARY OF BACKGROUND DATA. Spine fusions for idiopathic scoliosis are expected to be the final therapeutic intervention in management. In a recent publication in 2006, reoperations after index spine fusion for idiopathic scoliosis were reported in 12.9% of patients at a single institution (n = 1046). METHODS. A spinal deformity database search at our center identified all primary anterior, posterior, and circumferential spinal fusions performed for idiopathic scoliosis (1985-2003). A total of 1057 patients were identified whose mean age was 14.4 years (7-22 years) with minimum 2 year follow-up after index surgery. Study cohort consisted patients who underwent reoperation for any reason after index fusion procedure. RESULTS. Of the 1057 spinal fusions for idiopathic scoliosis, 41 (3.9%) underwent reoperation. Primary surgeries were: 11 anterior spinal fusions, 25 posterior spinal fusions, and 5 circumferential spinal fusions. Mean follow-up was 5.7 years (2-10.8). Forty-seven additional procedures were performed during 46 reoperations at an average of 26 months after index procedure (1 week-73 months). Of the 47 reoperations, 20 (43%) were revision spinal fusions (for pseudarthroses, uninstrumented curve progression or junctional kyphosis), 16 (34%) because of infections (5 acute, 11 chronic), 7 (15%) for implant removals due to pain and/or prominence (4 complete, 3 partial), 2 (4%) were revision of loosened implants, and 2 (4%) were elective thoracoplasties. CONCLUSION. This study documented a 3.9% overall reoperation rate at our medical center, a 3-fold lower reoperation rate than the previously reported 12.9%. The most common reoperations were for infections (34%), pseudarthroses (26%), and postoperative curve progression of the adjacent unfused spine (17%).
KW - Idiopathic scoliosis
KW - Infections
KW - Revision surgery
KW - Spinal pseudarthrosis
KW - Spine fusion
UR - http://www.scopus.com/inward/record.url?scp=70349730253&partnerID=8YFLogxK
U2 - 10.1097/BRS.0b013e3181b3515a
DO - 10.1097/BRS.0b013e3181b3515a
M3 - Article
C2 - 19752705
AN - SCOPUS:70349730253
SN - 0362-2436
VL - 34
SP - 2191
EP - 2197
JO - Spine
JF - Spine
IS - 20
ER -