Lewerenz Erik, Mohanty Sarthak, Hassan Fthimnir M, Lee Nathan J, Scheer Justin K, Hung Chun Wai, Roth Steven G, Lombardi Joseph M, Sardar Zeeshan M, Lehman Ronald A, Lenke Lawrence G
Department of Orthopaedic Surgery, The Och Spine Hospital at New York Presbyterian, Columbia University Irving Medical Center, 5141 Broadway, New York, NY, 10034, USA.
Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Spine Deform. 2025 Apr 3. doi: 10.1007/s43390-025-01083-2.
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.
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.
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.
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.
比较在初次手术后六个月内接受再次手术的成人脊柱畸形（ASD）患者与未再次入院/手术的患者的患者报告结局（PROs），并指出活动和疼痛结局方面的异同。
纳入在单一机构接受脊柱融合术且随访至少两年的ASD患者。将未再次入院/手术的患者（无再次手术）与那些在初次手术后六个月内需要进行早期再次手术的患者（早期再次手术）队列进行比较。结局包括2年PROs、改善情况和达到最小临床重要差异（MCID）。对SRS-22r中评估选择相同治疗可能性的问题22进行单独评估。
纳入238例患者[211例（89%）无再次手术；27例（11%）早期再次手术]。早期再次手术与近端交界性后凸/远端交界性后凸（29.63%，n = 8）、植入物移位（18.52%，n = 5）和椎弓根/椎体骨折（14.81%，n = 4）相关。在人口统计学、手术特征、基线对线和术前PROs方面没有差异。SRS活动（p = 0.392）、疼痛（p = 0.291）、外观（p = 0.179）、心理健康（p = 0.840）、满意度（p = 0.098）、总分（p = 0.152）和ODI（p = 0.564）的PRO改善没有显著差异。SRS活动（p = 0.536）、疼痛（p = 0.115）、外观（p = 0.269）、心理健康（p > 0.999）、满意度（p = 0.149）和ODI（p = 0.403）的MCID达成情况相当。无再次手术队列的SRS总分MCID达成率更高（82%对70%，p = 0.048）。此外，更大比例的无再次手术患者认可如果必须再次选择，他们会选择相同的手术治疗（86%对70%，p = 0.046）。
ASD手术后6个月内针对翻修手术原因进行的早期再次手术不会对两年的功能和疼痛结局产生不利影响。然而，只有70%的患者会再次选择相同的治疗，而未接受再次手术的患者中这一比例为86%，无再次手术队列的SRS22r总分MCID达成率更高。
