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Secondary Surgery Rates After Primary Fusion for Adolescent Idiopathic Scoliosis
Orthopedics
|May 29, 2019
Summary
Posterior pedicle screw constructs for adolescent idiopathic scoliosis (AIS) spinal fusion show lower revision surgery rates. This instrumentation also reduces the risk of pseudarthrosis compared to other methods.
Area of Science:
- Orthopedics
- Spine Surgery
- Pediatric Orthopedics
Background:
- Instrumented spinal fusion is the standard surgical treatment for adolescent idiopathic scoliosis (AIS).
- The primary goal is achieving stable fusion and avoiding revision surgeries.
- Understanding revision rates based on instrumentation is crucial for optimizing patient outcomes.
Purpose of the Study:
- To determine the surgical revision rates in adolescent idiopathic scoliosis (AIS) patients.
- To analyze these rates in relation to different spinal instrumentation constructs used during initial fusion.
- To identify factors influencing the need for secondary surgical procedures.
Main Methods:
- Retrospective chart review of AIS patients undergoing instrumented spinal fusion.
- Inclusion criteria: minimum 2-year follow-up.
- Data collected: demographics, implant type, surgical approach, and secondary operations.
Main Results:
- Out of 411 patients, 50 (12.2%) required 66 secondary operations.
- Common reasons for revision: symptomatic hardware, pseudarthrosis, and infection.
- Posterior pedicle screw constructs demonstrated a significantly lower secondary surgery rate (5.8%) compared to hybrid and combined fusions (P<.05).
Conclusions:
- Patients undergoing instrumented spinal fusion for AIS face a risk of subsequent surgery.
- Pedicle screw constructs are associated with a lower overall secondary surgery rate.
- Pedicle screw instrumentation also shows a statistically lower rate of pseudarthrosis, favoring its consideration in AIS treatment.
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