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Incidence of complete spinal instrumentation removal following surgery for spinal deformity: a 22-year single

Matthew V Abola1, Christina K Hardesty1,2, Derrick M Knapik1,2

  • 1School of Medicine, Case Western Reserve University.

Journal of Pediatric Orthopedics. Part B
|May 29, 2019
PubMed

Insights

The overall incidence of complete implant removal after pediatric scoliosis surgery is 4.7%. Infection is the most common reason for removal, followed by persistent pain and metal intolerance.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Spine Surgery
  • Spinal Deformity Correction

Background:

  • Surgical correction of spinal deformities is common in pediatric patients.
  • Complete implant removal after spinal fusion surgery can occur.
  • Identifying the incidence and risk factors for implant removal is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence of complete implant removal following spinal deformity correction in pediatric patients over a 22-year period.
  • To identify potential risk factors associated with implant removal.
  • To analyze indications for implant removal in this patient cohort.

Main Methods:

  • Retrospective review of a Pediatric Orthopedic Spine Database (1992-2016).
  • Inclusion criteria: pediatric patients undergoing complete implant removal after scoliosis correction with a minimum 2-year follow-up.
  • Data collected: initial diagnosis, indication for removal, patient demographics; statistical analysis performed.

Main Results:

  • A total of 1117 procedures in 1114 patients were reviewed, with 52 (4.7%) undergoing complete implant removal.
  • Mean time to removal was 2.3 years post-surgery.
  • Infection (46%) was the most frequent indication for removal, followed by persistent pain (15%) and metal intolerance (15%).

Conclusions:

  • The 22-year incidence of complete implant removal after pediatric scoliosis surgery is 4.7%.
  • Infection remains the primary indication for implant removal, highlighting the importance of infection prevention and management.
  • Persistent pain and metal intolerance are significant secondary indications requiring further investigation and management strategies.

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