Impact of early unanticipated revision surgery on health-related quality of life after adult spinal deformity surgery

Núñez-Pereira, Susana; Vila-Casademunt, Alba; Domingo-Sàbat, Montserrat; Bagó, Juan; Acaroğlu, Emre; Alanay, Ahmet; Obeid, Ibrahim; Pérez-Grueso, Francisco Javier Sánchez; Kleinstück, Frank; Pellisé, Ferràn

doi:10.1016/j.spinee.2017.09.017

Cited by 19 publications

(20 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 22 , 23 Not unexpected, a higher reoperation rate was observed in the high postoperative pain group; patients that were revised after index scoliosis surgery reported higher postoperative pain scores, worse quality of life and lower (worse) SRS-22r scores than the others. Our results, consistent with previous reports in the literature, 24 suggest that reoperation in scoliosis surgery is associated with a negative impact on clinical outcome and quality of life.…”

Section: Discussionsupporting

confidence: 93%

Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Charalampidis

Rundberg

Möller

et al. 2021

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Purpose: To identify factors contributing to persistent postoperative pain in patients treated surgically for idiopathic scoliosis. Methods: In total, 280 patients aged ten through 25 years at surgery, were identified in the Swedish Spine registry; all having preoperative and postoperative visual analogue scale (VAS) for back pain scores. The patients were divided into a high and low postoperative pain group based on the reported postoperative VAS for back pain scores (by using 45 mm on the 0 mm to 100 mm VAS scale as a cut-off). The patient-reported questionnaire included VAS for back pain, the 3-level version of EuroQol 5-dimensional (EQ-5D-3L) instrument, the EuroQol VAS (EQ-VAS) and the Scoliosis Research Society 22r instrument (SRS-22r). Predictors of postoperative back pain were searched in the preoperative data. Results: The 67 (24%) patients that reported high postoperative VAS back pain (> 45 mm) also reported lower postoperative EQ-5D-3L, EQ-VAS and SRS-22r than patients with low postoperative VAS back pain (all p < 0.001). Two preoperative variables were independently associated with postoperative pain; each millimetre increase in preoperative VAS back pain (on the 0 mm to 100 mm scale) was associated with a higher risk of being in the high postoperative back pain group (odds ratio (OR) 1.03; 95% confidence interval (CI) 1.02 to 1.05) and each 1 point decrease on the preoperative SRS-22r mental health (scale from 1 to 5) was associated with a higher risk of being in the high postoperative back pain group (OR 1.68; 95% CI 1.03 to 2.73). Conclusion: High preoperative back pain and low preoperative mental health are independent predictors of back pain after surgery for idiopathic scoliosis. Level of Evidence: III

show abstract

Section: Discussionsupporting

confidence: 93%

Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Charalampidis

Rundberg

Möller

et al. 2021

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

show abstract

“…In the past, these mechanical complications have been reported to result in reduced activities of daily living and the need for revision surgery. These unanticipated revision surgeries have also been reported to inhibit the improvement of PROs 21 . In this study, 37% of patients underwent one or more unanticipated reoperations.…”

Section: Discussionmentioning

confidence: 64%

“…These unanticipated revision surgeries have also been reported to inhibit the improvement of PROs. 21 In this study, 37% of patients underwent one or more unanticipated reoperations. From the standpoint of healthcare economics, it is important to minimize the number of unanticipated revision surgeries.…”

Section: Deformitymentioning

confidence: 73%

Clinical Outcomes of Corrective Fusion Surgery From the Thoracic Spine to the Pelvis for Adult Spinal Deformity at 1, 2, and 5 years Postoperatively

Arima

Hasegawa

Yamato

et al. 2022

Spine

View full text Add to dashboard Cite

Study Design. Retrospective cohort study. Objective. To investigate whether patient-reported outcomes (PROs) were consistent at 2 and 5 years after corrective fusion surgery from the thoracic spine to the pelvis in patients with adult spinal deformity (ASD) and to analyze whether revision surgery affected long-term outcomes.Summary of Background Data. PROs up to 2 years after corrective surgeries for ASD have been well-studied, but there are few reports of mid-to long-term results. Methods. We retrospectively analyzed patients with ASD who underwent corrective fusion surgery from the thoracic spine to the pelvis between 2010 and 2015. We investigated radiographic parameters and PROs (Scoliosis Research Society 22r [SRS-22r], Oswestry Disability Index [ODI]) preoperatively and at 1, 2, and 5 years postoperatively, and the correlations between PROs at these time points. We also compared changes in PROs at 5 years in patients who underwent revision surgery and those who did not. Results. A total of 131 patients who underwent corrective fusion surgery from the thoracic spine to the pelvis were analyzed. The PROs at 1 and 5 years after surgery showed significant correlations in all SRS-22r domains (function [r U 0.620], pain [r U 0.577], self-image [r U 0.563], mental health [r U 0.589], subtotal [r U 0.663], and ODI [r U 0.654]). The PROs at 2 and 5 years after surgery showed significantly strong correlations in all domains (functionsubtotal [r U 0.741], and ODI [r U 0.746]). There were no significant differences in the change in PROs at 5 years in any domain in patients who underwent revision surgery (all P > 0.05). Conclusion. One-year postoperative PROs improved significantly. Two-year PROs correlated strongly with 5-year postoperative PROs, indicating that 2-year PROs can predict longer term outcomes. The need for revision surgery did not influence the mid-to long-term clinical outcomes of corrective fusion surgery for ASD.

show abstract

“…[3][4][5] Furthermore, there are disadvantages of fusions ending at lumbar levels (L4 or L5), such as symptomatic adjacent distal disc degeneration, leading to a loss of lumbar lordosis (LL), sagittal decompensation, and the need to extend the fixation to the sacrum. 2 This is coupled with high reported revision rates within 1 year (12.5%-15.4%), 10,11 2.1 years (28.2%), 12 and 3.3 years (32%) of follow-up. 6 Therefore, the risks and benefits of selecting distal fusion levels should be carefully evaluated.…”

Section: Introductionmentioning

confidence: 99%

Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up

Kim

Bannwarth

et al. 2021

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Retrospective cohort study. Objective: To compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium. Methods: A multicenter ASD database was evaluated. Patients were categorized into 2 groups based on LIV levels—groups L (fusion to L4/L5) and S (fusion to S1/ilium). Both groups were propensity matched by age and preoperative radiographic alignments. Patient demographics, operative details, radiographic parameters, revision rates, and health-related quality of life (HRQOL) scores were compared. Results: Overall, 349 patients had complete data, with a mean follow-up of 46 months. Patients in group S (n = 311) were older and had larger sagittal and coronal plane deformities than those in group L (n = 38). After matching, 28 patients were allocated to each group with similar demographic, radiographic, and clinical parameters. Sagittal alignment restoration at postoperative week 6 was significantly better in group S than in group L, but it was similar in both groups at the 2-year follow-up. Fusion to S1/ilium involved a longer operating time, higher PJK rates, and greater PJK angles than that to L4/L5. There were no significant differences in the complication and revision rates between the groups. Both groups showed significant improvements in HRQOL scores. Conclusions: Fusion to S1/ilium had better sagittal alignment restoration at postoperative week 6 and involved higher PJK rates and greater PJK angles than that to L4/L5. The clinical outcomes and rates of revision surgery and complications were similar between the groups.

show abstract

Impact of early unanticipated revision surgery on health-related quality of life after adult spinal deformity surgery

Cited by 19 publications

References 30 publications

Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Predictors of persistent postoperative pain after surgery for idiopathic scoliosis

Clinical Outcomes of Corrective Fusion Surgery From the Thoracic Spine to the Pelvis for Adult Spinal Deformity at 1, 2, and 5 years Postoperatively

Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up

Contact Info

Product

Resources

About