1-Year Post-Operative Radiographic and Patient-Reported Outcomes following Cervical Deformity Correction are not Affected by a Short-Term Unplanned Return to the OR.

Abstract

Study design

Retrospective analysis of a prospectively-collected multi-center database.

Objective

Assess the radiographic and health-related quality of life (HRQoL) impact of a short term (<1 y) return to the OR after adult cervical spine deformity (ACSD) surgery.

Summary of background data

Returns to the OR within a year of ACSD correction can be particularly devastating to these vulnerable hosts as they often involve compromise of the soft tissue envelope, neurologic deficits or hardware failure. This work sought to assess the impact of a short-term reoperation on 1-year radiographic and HRQoL outcomes.

Methods

Patients operated on from 1/1/2013 to 1/1/2019 with at least 1-year of follow-up were included. The primary outcome was a short-term return to the OR. Variables of interest included patient demographics, Charlson Comorbidity Index (CCI), HRQoL measured with the Modified Japanese Orthopaedic Association (mJOA), Neck Disability Index (NDI) and EuroQuol-5D visual analogue scale (EQ-5D VAS) and radiographic outcomes, including T1-slope (TS), C2-C7 sagittal cobb angle (CL), TS-CL and cervical sagittal vertical axis (cSVA). Comparisons between those who did versus did not require a 1-year reoperation were performed using paired t-tests. A Kaplan Meier survival curve was used to estimate reoperation-free survival up to 2-years post-operatively.

Results

A total of 121 patients were included in this work (age 61.9±10.1 y, BMI 28.4±6.9, CCI 1.0±1.4, 62.8% female). A 1-year unplanned return to the OR was required for 28 (23.1%) patients, of whom 19 followed-up for at least 1-year. Indications for a return to the OR were most commonly for neurologic complications (5%), infectious/wound complications (5.8%) and junctional failure (6.6%) No differences in demographics, comorbidities, pre-operative or 1-year post-operative HRQoL or radiographic outcomes were seen between operative groups.

Conclusion

Reoperation <1 year after ACSD surgery did not influence 1-year radiographic outcomes or HRQoL.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1097/brs.0000000000004614

Publication Info

Fourman, Mitchell S, Renaud Lafage, Christopher Ames, Justin S Smith, Peter G Passias, Christopher I Shaffrey, Gregory Mundis, Themistocles Protopsaltis, et al. (2023). 1-Year Post-Operative Radiographic and Patient-Reported Outcomes following Cervical Deformity Correction are not Affected by a Short-Term Unplanned Return to the OR. Spine, Publish Ahead of Print. 10.1097/brs.0000000000004614 Retrieved from https://hdl.handle.net/10161/27971.

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Scholars@Duke

Shaffrey

Christopher Ignatius Shaffrey

Professor of Orthopaedic Surgery

I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.


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