*Shriners Hospitals for Children, Philadelphia, PA †Rady Children's Hospital, San Diego, CA ‡British Columbia Children's Hospital, Vancouver, BC, Canada §Miami Children's Hospital, Miami, FL; and ¶NYU Hospital for Joint Diseases, New York, NY.
Spine (Phila Pa 1976). 2013 Oct 1;38(21):1842-7. doi: 10.1097/BRS.0b013e3182a42a99.
Prospective, longitudinal cohort.
To evaluate the incidence, timing, and risk factors for reoperation in patients with adolescent idiopathic scoliosis (AIS) treated with pedicle screws (PSs) compared with hybrid (Hb) constructs.
Rates of return to the operating room (OR) after definitive fusion for AIS vary, with a paucity of data on PS constructs.
A prospective multicenter database was retrospectively queried to identify consecutive patients with AIS who underwent posterior spinal fusion with either PS or Hb constructs with a minimum 2-year follow-up. All reoperations were stratified into an early group (<60 d) or a late group (>60 d). Univariate and multivariate logistical analyses were performed to identify potential risk factors related to reoperation.
A total of 627 patients met the inclusion criteria (PS = 540, Hb = 87). There was a statistically significant difference in the rate of reoperations between the PS (3.5%) and Hb groups (12.6%), P < 0.001. Early return to the OR occurred in 2.0% of the patients with PS compared with 3.4% in the Hb group, P = 0.43. Late returns to the OR occurred in 1.5% of PS group versus 9.2% of the Hb group, P < 0.001. Multivariate analysis revealed longer operating time as an independent risk factor for an unplanned return to the OR in patients treated with PSs (P < 0.05).
Our results suggest that patients with AIS treated with PS have decreased rates of unplanned return to the OR when compared with patients with Hb constructs. The majority of returns to the OR were early (<60 d) for the PS group compared with late (>60 d) for the Hb group. Longer operative times increased the risk of unplanned reoperation for the PS group.
前瞻性、纵向队列研究。
评估与混合（Hb）结构相比，使用椎弓根螺钉（PS）治疗青少年特发性脊柱侧凸（AIS）患者的再手术发生率、时间和危险因素。
AIS 患者接受确定性融合后返回手术室（OR）的比率各不相同，关于 PS 结构的数据很少。
回顾性查询前瞻性多中心数据库，以确定接受 PS 或 Hb 结构后路脊柱融合术且至少随访 2 年的连续 AIS 患者。所有再手术均分为早期（<60 d）或晚期（>60 d）组。进行单变量和多变量逻辑分析以确定与再手术相关的潜在危险因素。
共有 627 名患者符合纳入标准（PS=540，Hb=87）。PS 组（3.5%）和 Hb 组（12.6%）的再手术率存在统计学差异，P<0.001。PS 组患者早期返回 OR 的发生率为 2.0%，Hb 组为 3.4%，P=0.43。PS 组晚期返回 OR 的发生率为 1.5%，Hb 组为 9.2%，P<0.001。多变量分析显示，手术时间较长是 PS 组患者计划外返回 OR 的独立危险因素（P<0.05）。
与 Hb 结构组相比，我们的结果表明，AIS 患者使用 PS 治疗时，计划外返回 OR 的比率降低。PS 组的大部分再手术是早期（<60 d），而 Hb 组是晚期（>60 d）。较长的手术时间增加了 PS 组计划外再手术的风险。
3。
