Failure in Adult Spinal Deformity Surgery

Abstract

Study Design. Literature review.Objective. The aim of this review is to summarize recent literature on adult spinal deformity (ASD) treatment failure as well as prevention strategies for these failure modes. Summary of Background Data. There is substantial evidence that ASD surgery can provide significant clinical benefits to patients. The volume of ASD surgery is increasing, and significantly more complex procedures are being performed, especially in the aging population with multiple comorbidities. Although there is potential for significant improvements in pain and disability with ASD surgery, these procedures continue to be associated with major complications and even outright failure. Methods. A systematic search of the PubMed database was performed for articles relevant to failure after ASD surgery. Institutional review board approval was not needed.Results. Failure and the potential need for revision surgery generally fall into 1 of 4 well-defined phenotypes. . clinical failure, radiographic failure, the need for reoperation, and lack of costeffectiveness. Revision surgery rates remain relatively high, challenging the overall cost-effectiveness of these procedures. Conclusion. By consolidating the key evidence regarding failure, further research and innovation may be stimulated with the goal of significantly improving the safety and cost-effectiveness of ASD surgery.

Optimizing Preoperative Chronic Pain Management in Elective Spine Surgery Patients

“…ASD patients are unique among spinal surgery patients because their cases involve multifactorial complications that require higher levels of revisions than other types of spine surgeries 21,22 . There has been a significant increase in ASD cases in the past 2 decades.…”

Satellite Rod Fixation around Rod‐fracture Area in Revision Surgery after Three‐column Osteotomy for Severe Kyphoscoliosis

“…9,10 The implant failure, however, was unfortunately observed in certain revised patients possibly due to uneven strength of rods, pseudarthrosis, coronal or sagittal imbalance. 11 In addition, replacing the broken rods through the entire former incision was not always the cost-effective option for this cohort due to the extensive surgical invasion.…”

“…Traditional revision strategies for rod breakage after 3CO mainly included replacing the broken rods and bone grafting via combined anterior and posterior approach or posterior‐only approach, by which most patients could attain satisfactory clinical outcomes 9,10 . The implant failure, however, was unfortunately observed in certain revised patients possibly due to uneven strength of rods, pseudarthrosis, coronal or sagittal imbalance 11 . In addition, replacing the broken rods through the entire former incision was not always the cost‐effective option for this cohort due to the extensive surgical invasion.…”

Composition of the editorial staff of major spinal journals based on geo-economic background: A survey analysis

“…Spinal diseases encompass a range of conditions that affect the vertebral column, leading to structural alterations or damage to the spinal cord and surrounding tissues [ 1 , 2 ]. These conditions, which include trauma, degeneration, infection, tumors, and scoliosis, often result in pain and disability, particularly when they exert pressure on the spinal cord or nerves [ 3 , 4 ]. Over the past few decades, significant advancements have occurred in spinal research [ 1 , 2 , 4 , 5 ].…”

“…These conditions, which include trauma, degeneration, infection, tumors, and scoliosis, often result in pain and disability, particularly when they exert pressure on the spinal cord or nerves [ 3 , 4 ]. Over the past few decades, significant advancements have occurred in spinal research [ 1 , 2 , 4 , 5 ]. The publication of research findings is integral to the progression of both clinical and foundational research, while also providing essential guidance for surgical interventions in the realm of spinal disorders [ [6] , [7] , [8] , [9] , [10] , [11] ].…”