Postoperative Radiographic Evaluation Following Adult Spine Deformity Correction: The Impact on Subsequent Management...

During the follow-up visits after Adult Spine Deformity (ASD) surgery, obtaining surveillance radiographs is a usual practice, and this study tried to identify evidence to support or refute such practice.

This is a retrospective, diagnostic case series (Level IV) of 49 patients. We identified the abnormal radiographic findings and their association with need for revision surgery. We determined the odds of obtaining an abnormal radiographs that lead to revision surgery at each of the given time intervals of follow-up. We also estimated the risk versus benefit of obtaining radiographs at each of the given time intervals of follow-up.

We identified a total of 11 individual types of abnormal postoperative radiographic findings. Of them, the two radiographic findings that always needed revision surgery because of the associated clinical presentation were pedicle screw pullout and bilateral rod fracture. One abnormal radiographic finding that was never associated with revision surgery was the halo around a pedicle screw. In each of the given postoperative time intervals of follow-up at which the routine radiographs were obtained, we noted that the odds of noticing abnormal radiographic finding that lead to revision surgery was always >1. We found that the cumulative hazard rate for exposure to radiation was significantly higher during the initial follow-up visits when compared to subsequent follow-up visits.

This study finds evidence to support the practice of routine postoperative radiographic evaluation of patients who come for follow-up after ASD surgery.