Long-term Morbidity in Patients After Surgical Correction of Adult Spinal Deformity: Results From a Cohort With Minimum 5-year Follow-up.

dc.contributor.author

Imbo, Bailey

dc.contributor.author

Williamson, Tyler

dc.contributor.author

Joujon-Roche, Rachel

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Krol, Oscar

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Tretiakov, Peter

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Ahmad, Salman

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Bennett-Caso, Claudia

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Schoenfeld, Andrew J

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Dinizo, Michael

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De La Garza-Ramos, Rafael

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Janjua, M Burhan

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Vira, Shaleen

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Ihejirika-Lomedico, Rivka

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Raman, Tina

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O'Connell, Brooke

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Maglaras, Constance

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Paulino, Carl

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Diebo, Bassel

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Lafage, Renaud

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Lafage, Virginie

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Passias, Peter G

dc.date.accessioned

2024-12-05T17:47:52Z

dc.date.available

2024-12-05T17:47:52Z

dc.date.issued

2023-08

dc.description.abstract

Study design

Retrospective.

Objective

The objective of this study is to describe the rate of postoperative morbidity before and after two-year (2Y) follow-up for patients undergoing surgical correction of adult spinal deformity (ASD).

Summary of background data

Advances in modern surgical techniques for deformity surgery have shown promising short-term clinical results. However, the permanence of radiographic correction, mechanical complications, and revision surgery in ASD surgery remains a clinical challenge. Little information exists on the incidence of long-term morbidity beyond the acute postoperative window.

Methods

ASD patients with complete baseline and five-year (5Y) health-related quality of life and radiographic data were included. The rates of adverse events, including proximal junctional kyphosis (PJK), proximal junctional failure (PJF), and reoperations up to 5Y were documented. Primary and revision surgeries were compared. We used logistic regression analysis to adjust for demographic and surgical confounders.

Results

Of 118 patients eligible for 5Y follow-up, 99(83.9%) had complete follow-up data. The majority were female (83%), mean age 54.1 years and 10.4 levels fused and 14 undergoing three-column osteotomy. Thirty-three patients had a prior fusion and 66 were primary cases. By 5Y postop, the cohort had an adverse event rate of 70.7% with 25 (25.3%) sustaining a major complication and 26 (26.3%) receiving reoperation. Thirty-eight (38.4%) developed PJK by 5Y and 3 (4.0%) developed PJF. The cohort had a significantly higher rate of complications (63.6% vs. 19.2%), PJK (34.3% vs. 4.0%), and reoperations (21.2% vs. 5.1%) before 2Y, all P <0.01. The most common complications beyond 2Y were mechanical complications.

Conclusions

Although the incidence of adverse events was high before 2Y, there was a substantial reduction in longer follow-up indicating complications after 2Y are less common. Complications beyond 2Y consisted mostly of mechanical issues.
dc.identifier

00007632-990000000-00313

dc.identifier.issn

0362-2436

dc.identifier.issn

1528-1159

dc.identifier.uri

https://hdl.handle.net/10161/31769

dc.language

eng

dc.publisher

Ovid Technologies (Wolters Kluwer Health)

dc.relation.ispartof

Spine

dc.relation.isversionof

10.1097/brs.0000000000004681

dc.rights.uri

https://creativecommons.org/licenses/by-nc/4.0

dc.subject

Humans

dc.subject

Kyphosis

dc.subject

Postoperative Complications

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Spinal Fusion

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Incidence

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Retrospective Studies

dc.subject

Follow-Up Studies

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Quality of Life

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Adult

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Middle Aged

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Female

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Male

dc.title

Long-term Morbidity in Patients After Surgical Correction of Adult Spinal Deformity: Results From a Cohort With Minimum 5-year Follow-up.

dc.type

Journal article

duke.contributor.orcid

Passias, Peter G|0000-0002-1479-4070|0000-0003-2635-2226

pubs.begin-page

1089

pubs.end-page

1094

pubs.issue

15

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Orthopaedic Surgery

pubs.publication-status

Published

pubs.volume

48

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