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Purpose <p>To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.</p> Methods <p>ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.</p> Results <p>238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK&#xa0;(29.63%, <i>n</i> = 8), implant dislodgement&#xa0;(18.52%, <i>n</i> = 5), and pedicle/vertebral fracture (14.81%, <i>n</i> = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (<i>p</i> = 0.392), Pain (<i>p</i> = 0.291), Appearance (<i>p</i> = 0.179), Mental Health (<i>p</i> = 0.840), Satisfaction (<i>p</i> = 0.098), Total score (<i>p</i> = 0.152), and ODI (<i>p</i> = 0.564). MCID achievement was comparable for SRS Activity (<i>p</i> = 0.536), Pain (<i>p</i> = 0.115), Appearance (<i>p</i> = 0.269), Mental Health (<i>p</i> &gt; 0.999), Satisfaction (<i>p</i> = 0.149), and ODI (<i>p</i> = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, <i>p</i> = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, <i>p</i> = 0.046) if they had to choose again.</p> Conclusion <p>Early reoperations within 6&#xa0;months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn’t undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.</p>

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Early reoperations do not adversely affect long-term pain and activity scores in adult deformity patients

  • 期刊论文

  • 发表日期：

    2025年4月3日

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  • Erik Lewerenz,
  • Sarthak Mohanty,
  • Fthimnir M. Hassan,
  • Nathan J. Lee,
  • Justin K. Scheer,
  • Chun Wai Hung,
  • Steven G. Roth,
  • Joseph M. Lombardi,
  • Zeeshan M. Sardar,
  • Ronald A. Lehman,
  • Lawrence G. Lenke

摘要

Purpose

To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.

Methods

ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.

Results

238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again.

Conclusion

Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn’t undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.