Predictors of Revision Surgery in Adult Spinal Deformity and Impact on Patient-Reported Outcomes and Satisfaction: Two-Year Follow-Up

2014 ◽  
Vol 14 (11) ◽  
pp. S21 ◽  
Author(s):  
Peter G. Passias ◽  
Sun Yang ◽  
Alexandra Soroceanu ◽  
Justin S. Smith ◽  
Christopher I. Shaffrey ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Surgery ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Patient Reported

Complications and Patient-Reported Outcomes of Primary versus Revision Surgery for Severe Adult Spinal Deformity: A ScoliRisk-1 Sub-Analysis

2016 ◽  
Vol 16 (10) ◽  
pp. S326-S327
Author(s):  
Amit Jain ◽  
Floreana Naef ◽  
Lawrence G. Lenke ◽  
Christopher I. Shaffrey ◽  
Michael G. Fehlings ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Surgery ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Patient Reported

scholarly journals Impact of obesity on complications, infection, and patient-reported outcomes in adult spinal deformity surgery

2015 ◽  
Vol 23 (5) ◽  
pp. 656-664 ◽  
Author(s):  
Alex Soroceanu ◽  
Douglas C. Burton ◽  
Bassel Georges Diebo ◽  
Justin S. Smith ◽  
Richard Hostin ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Surgery ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Complication Rates ◽  
Obese Patients ◽  
Estimated Blood Loss ◽  
Sf 36 ◽  
Patient Reported ◽  
The Impact

OBJECT Adult spinal deformity (ASD) surgery is known for its high complication rate. This study examined the impact of obesity on complication rates, infection, and patient-reported outcomes in patients undergoing surgery for ASD. METHODS This study was a retrospective review of a multicenter prospective database of patients with ASD who were treated surgically. Patients with available 2-year follow-up data were included. Obesity was defined as having a body mass index (BMI) ≥ 30 kg/m2. Data collected included complications (total, minor, major, implant-related, radiographic, infection, revision surgery, and neurological injury), estimated blood loss (EBL), operating room (OR) time, length of stay (LOS), and patient-reported questionnaires (Oswestry Disability Index [ODI], Short Form-36 [SF-36], and Scoliosis Research Society [SRS]) at baseline and at 6 weeks, 1 year, and 2 years postoperatively. The impact of obesity was studied using multivariate modeling, accounting for confounders. RESULTS Of 241 patients who satisfied inclusion criteria, 175 patients were nonobese and 66 were obese. Regression models showed that obese patients had a higher overall incidence of major complications (IRR 1.54, p = 0.02) and wound infections (odds ratio 4.88, p = 0.02). Obesity did not increase the number of minor complications (p = 0.62), radiographic complications (p = 0.62), neurological complications (p = 0.861), or need for revision surgery (p = 0.846). Obesity was not significantly correlated with OR time (p = 0.23), LOS (p = 0.9), or EBL (p = 0.98). Both groups experienced significant improvement overtime, as measured on the ODI (p = 0.0001), SF-36 (p = 0.0001), and SRS (p = 0.0001) questionnaires. However, the overall magnitude of improvement was less for obese patients (ODI, p = 0.0035; SF-36, p = 0.0012; SRS, p = 0.022). Obese patients also had a lower rate of improvement over time (SRS, p = 0.0085; ODI, p = 0.0001; SF-36, p = 0.0001). CONCLUSIONS This study revealed that obese patients have an increased risk of complications following ASD correction. Despite these increased complications, obese patients do benefit from surgical intervention; however, their improvement in health-related quality of life (HRQL) is less than that of nonobese patients.

Minimum 10-Year Outcomes of Primary Arthroscopic Transosseous-Equivalent Double-Row Rotator Cuff Repair

2021 ◽  
pp. 036354652110154
Author(s):  
Adam M. Johannsen ◽  
Justin W. Arner ◽  
Bryant P. Elrick ◽  
Philip-C. Nolte ◽  
Dylan R. Rakowski ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Revision Surgery ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcomes ◽  
Long Term Results ◽  
Double Row ◽  
Kaplan Meier ◽  
Patient Reported ◽  
Cuff Repair

Background: Modern rotator cuff repair techniques demonstrate favorable early and midterm outcomes, but long-term results have yet to be reported. Purpose: To determine 10-year outcomes and survivorship after arthroscopic double-row transosseous-equivalent (TOE) rotator cuff repair. Study Design: Case series; Level of evidence 4. Methods: The primary TOE rotator cuff repair procedure was performed using either a knotted suture bridge or knotless tape bridge technique on a series of patients with 1 to 3 tendon full-thickness rotator cuff tears involving the supraspinatus. Only patients who were 10 years postsurgery were included. Patient-reported outcomes were collected pre- and postoperatively, including American Shoulder and Elbow Surgeons (ASES), 12-Item Short Form Health Survey (SF-12), Single Assessment Numeric Evaluation (SANE), shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and satisfaction. Kaplan-Meier survivorship analysis was performed. Failure was defined as progression to revision surgery. Results: A total of 91 shoulders (56 men, 31 women) were included between October 2005 and December 2009. Mean follow-up was 11.5 years (range, 10.0-14.1 years). Of 91 shoulders, 5 (5.5%) failed and required revision surgery. Patient-reported outcomes for patients who survived were known for 80% (69/86). Outcomes scores at final follow-up were as follows: ASES, 93.1 ± 10.8; SANE, 87.5 ± 14.2; QuickDASH, 11.1 ± 13.5; and SF-12 physical component summary (PCS), 49.2 ± 10.1. There were statistically significant declines in ASES, SANE, and SF-12 PCS from the 5-year to 10-year follow-up, but none of these changes met the minimally clinically important difference threshold. Median satisfaction at final follow-up was 10 (range, 3-10). From this cohort, Kaplan-Meier survivorship demonstrated a 94.4% survival rate at a minimum of 10 years. Conclusion: Arthroscopic TOE rotator cuff repair demonstrates high patient satisfaction and low revision rates at a mean follow-up of 11.5 years. This information may be directly utilized in surgical decision making and preoperative patient counseling regarding the longevity of modern double-row rotator cuff repair.

Postoperative Coronal Malalignment is Associated with Significantly Poor Patient Reported Outcomes in Operatively Treated Adult Spinal Deformity

2015 ◽  
Vol 15 (10) ◽  
pp. S148-S149 ◽  
Author(s):  
International Spine Study Group ◽  
Amit Jain ◽  
Christopher P. Ames ◽  
Brian J. Neuman ◽  
Daniel M. Sciubba ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Poor Patient ◽  
Patient Reported ◽  
Coronal Malalignment

scholarly journals Treatment strategy for rod fractures following corrective fusion surgery in adult spinal deformity depends on symptoms and local alignment change

2018 ◽  
Vol 29 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Yu Yamato ◽  
Tomohiko Hasegawa ◽  
Sho Kobayashi ◽  
Tatsuya Yasuda ◽  
Daisuke Togawa ◽  
...  
Keyword(s):  
Spinal Deformity ◽  
Revision Surgery ◽  
Treatment Strategy ◽  
Time Course ◽  
Clinical Symptoms ◽  
Adult Spinal Deformity ◽  
Nonoperative Treatment ◽  
Local Alignment ◽  
Fusion Surgery

OBJECTIVEDespite the significant incidence of rod fractures (RFs) following long-segment corrective fusion surgery, little is known about the optimal treatment strategy. The objectives of this study were to investigate the time course of clinical symptoms and treatments in patients with RFs following adult spinal deformity (ASD) surgery and to establish treatment recommendations.METHODSThis study was a retrospective case series of patients with RFs whose data were retrieved from a prospectively collected single-center database. The authors reviewed the cases of 304 patients (mean age 62.9 years) who underwent ASD surgery. Primary symptoms, time course of symptoms, and treatments were investigated by reviewing medical records. Standing whole-spine radiographs obtained before and after RF development and at last follow-up were evaluated. Osseous union was assessed using CT scans and intraoperative findings.RESULTSThere were 54 RFs in 53 patients (mean age 68.5 years [range 41–84 years]) occurring at a mean of 21 months (range 6–47 months) after surgery. In 1 patient RF occurred twice, with each case at a different time and level, and the symptoms and treatments for these 2 RFs were analyzed separately (1 case of revision surgery and 1 case of nonoperative treatment). The overall rate of RF observed on radiographs after a minimum follow-up of 1 year was 18.0% (54 of 300 cases). The clinical symptoms at the time of RF were pain in 77.8% (42 of 54 cases) and no onset of new symptoms in 20.5% (11 of 54 cases). The pain was temporary and had subsided in 19 of 42 cases (45%) within 2 weeks. In 36 of the 54 cases (66.7%) (including the first RF in the patient with 2 RFs), patients underwent revision surgery at a mean of 116 days (range 5–888 days) after diagnosis. In 18 cases patients received only nonoperative treatment as of the last follow-up, including 17 cases in which the patients experienced no pain and no remarkable progression of deformity (mean 18.5 months after RF development).CONCLUSIONSThis analysis of 54 RFs in 53 patients following corrective fusion surgery for ASD demonstrates a relationship between symptoms and alignment change. Revision surgeries were performed in a total of 36 cases. Nonoperative care was offered in 18 (33.3%) of 54 cases at the last follow-up, with no additional symptoms in 17 of the 18 cases. These data offer useful information regarding informed decision making for patients in whom an RF occurs after ASD surgery.

68. Early patient-reported outcomes can be used to identify patients at risk for poor 1-year outcomes in adult spinal deformity

2019 ◽  
Vol 19 (9) ◽  
pp. S34
Author(s):  
Alvaro Ibaseta ◽  
Rafa Rahman ◽  
Nicholas S. Andrade ◽  
Richard L. Skolasky ◽  
Lee H. Riley ◽  
...  
Keyword(s):  
At Risk ◽  
Spinal Deformity ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Patient Reported ◽  
Patients At Risk

scholarly journals Postoperative Cervical Deformity in 215 Thoracolumbar Adult Spinal Deformity Patients: Prevalence, Risk Factors, and Impact on Patient-Reported Outcome and Satisfaction at 2-Year Follow-Up

2015 ◽  
Vol 5 (1_suppl) ◽  
pp. s-0035-1554517-s-0035-1554517
Author(s):  
Peter Passias ◽  
Justin Smith ◽  
Alex Soroceanu ◽  
Anthony Boniello ◽  
Justin Scheer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Deformity ◽  
Adult Spinal Deformity ◽  
Patient Reported Outcome ◽  
Cervical Deformity ◽  
Patient Reported

scholarly journals Long-term clinical and radiographic outcomes and patient satisfaction after adult spinal deformity correction

2018 ◽  
Vol 108 (4) ◽  
pp. 343-351 ◽  
Author(s):  
K. Kyrölä ◽  
H. Kautiainen ◽  
L. Pekkanen ◽  
P. Mäkelä ◽  
I. Kiviranta ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Spinal Deformity ◽  
Oswestry Disability Index ◽  
Patient Reported Outcomes ◽  
Adult Spinal Deformity ◽  
Deformity Correction ◽  
Research Society ◽  
Scoliosis Research Society ◽  
Patient Reported ◽  
Poor Outcomes

Background and Aims: Adult spinal deformity surgery has increased with the aging population and modern surgical approaches, although it has high complication and reoperation rates. The permanence of radiographic correction, mechanical complications, predictive factors for poor patient-reported outcomes, and patient satisfaction were analyzed. Material and Methods: A total of 79 adult patients were retrospectively analyzed at baseline and 1–9 years after adult spinal deformity correction between 2007 and 2016. Patient-reported outcomes (Oswestry Disability Index, visual analog scale, and Scoliosis Research Society–30 scores), changes in radiographic alignment, indications for reoperation, predictors of poor outcomes according to the Oswestry Disability Index and Scoliosis Research Society–30 scores, and patient satisfaction with management were studied. Results: Oswestry Disability Index and visual analog scale scores (p = 0.001), radiographic correction of thoracic kyphosis, lumbar lordosis, and pelvic retroversion (p ⩽ 0.001) and sagittal vertical axis (p = 0.043) were significantly better at 4–5 years of follow-up than at baseline. The risk for the first reoperation owing to mechanical failure of instrumentation or bone was highest within the first year, at 13.9% (95% confidence interval = 8.0%–23.7%), and 29.8% (95% confidence interval = 19.4%–43.9%) at the 5-year follow-up. Oswestry Disability Index and Scoliosis Research Society–30 total scores had a good correlation (r = −0.78; 95% CI = −0.86 to –0.68; p < 0.001). Satisfaction with management was correlated with patient-reported outcomes. Male sex and depression (p = 0.021 and 0.018, respectively) predicted poor outcomes according to the Oswestry Disability Index and/or Scoliosis Research Society–30 score. Conclusion: The achieved significant radiographic correction was maintained 5 years postoperatively. Despite reoperations, patient satisfaction and clinical outcomes were good. Depression and male sex predicted poor clinical outcomes.

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