Cerpa Meghan, Zuckerman Scott L, Lenke Lawrence G, Carreon Leah Y, Cheung Kenneth M C, Kelly Michael P, Fehlings Michael G, Ames Christopher P, Boachie-Adjei Oheneba, Dekutoski Mark B, Kebaish Khaled M, Lewis Stephen J, Matsuyama Yukihiro, Pellisé Ferran, Qiu Yong, Schwab Frank J, Smith Justin S, Shaffrey Christopher I
Department of Orthopaedic Surgery, New York Presbyterian, The Daniel and Jane Och Spine Hospital, Columbia University Medical Center, Broadway, New York, NY, 5141, 10034, USA.
Vanderbilt Univerity Medical Center, Nashville, TN, USA.
Eur Spine J. 2025 May;34(5):1790-1800. doi: 10.1007/s00586-025-08683-6. Epub 2025 Feb 12.
To report all complications that occurred during the 2 to 5-year postoperative period, describe reoperations during this time period, and compare patients who did and did not have major, surgery-related complications and/or reoperations during this time period.
The Scoli-RISK-1 study enrolled 272 ASD patients undergoing surgery from 15 centers. Inclusion criteria were Cobb angle of > 80°, corrective osteotomy for congenital/revision deformity, and/or 3-column osteotomy. At each follow-up visit, any neurologic or non-neurologic adverse event(AE) was documented & categorized.
77 patients had a minimum 5-year follow-up. 35 surgery-related AE's occurred during the 2 to 5-year period in 25(32.5%) patients. 23/35(65.7%) major, surgery-related complications occurred in 17 patients, 22/35(62.9%) requiring reoperations in 16 patients. Rod fracture and/or pseudarthrosis was the most common complication. The most common minor, surgery-related complication was asymptomatic rod fractures with no alignment changes. Four neurological complications were reported, one of which did not require reoperation. One death occurred at 6.1 years postoperative after multiple reoperations for mechanical complications. 14/17(82.4%) patients with major, surgery-related complication had a preceding AE during the initial 2-year postoperative period. 53 non-surgery-related AEs occurred in 21(27.3%) patients with musculoskeletal(37.7%) occurring most often. No differences were observed in ODI or SRS-22r in those with/without major surgery-related complications or those with/without reoperation.
During the study period, 25(32.5%) patients experienced 35 surgery-related complications, of which 23(65.7%) were major. Rod fracture with pseudarthrosis was the most common major, surgery-related complication. Neurologic complications were not found to be major drivers of reoperation. Surprisingly, PROs were similar in those with/without a major, surgery-related complication during the study period. This work has been presented as a podium presentation at the 55th Scoliosis Research Society annual meeting, Sep 9-13, 2020.
报告术后2至5年期间发生的所有并发症，描述该时间段内的再次手术情况，并比较在此期间发生和未发生重大手术相关并发症及/或再次手术的患者。
Scoli-RISK-1研究纳入了来自15个中心的272例接受手术的青少年特发性脊柱侧凸（ASD）患者。纳入标准为Cobb角>80°、先天性/翻修畸形的矫正截骨术和/或三柱截骨术。在每次随访时，记录并分类任何神经或非神经不良事件（AE）。
77例患者至少随访5年。在2至5年期间，25例（32.5%）患者发生了35例手术相关AE。17例患者发生了23/35例（65.7%）重大手术相关并发症，16例患者中22/35例（62.9%）需要再次手术。棒材骨折和/或假关节是最常见的并发症。最常见的轻微手术相关并发症是无症状的棒材骨折且无对线改变。报告了4例神经并发症，其中1例无需再次手术。1例患者在术后6.1年因机械并发症多次再次手术后死亡。17例发生重大手术相关并发症的患者中，14/17例（82.4%）在术后最初2年内有先前的AE。21例（27.3%）患者发生了53例非手术相关AE，其中肌肉骨骼方面的AE最常见（37.7%）。在有/无重大手术相关并发症或有/无再次手术的患者中，未观察到Oswestry功能障碍指数（ODI）或脊柱侧凸研究学会22项问卷修订版（SRS-22r）有差异。
在研究期间，25例（32.5%）患者发生了35例手术相关并发症，其中23例（65.7%）为重大并发症。棒材骨折合并假关节是最常见的重大手术相关并发症。神经并发症并非再次手术的主要驱动因素。令人惊讶的是，在研究期间，有/无重大手术相关并发症的患者的患者报告结局（PRO）相似。这项工作已在2020年9月9日至13日举行的第55届脊柱侧凸研究学会年会上作为大会发言展示。
