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Failure in Adult Spinal Deformity Surgery: A Comprehensive Review of Current Rates, Mechanisms, and Prevention
John F Burke1, Justin K Scheer1, Darryl Lau2
1Department of Neurological Surgery, University of California, San Francisco, CA.
Spine
|September 12, 2022
Summary
Adult spinal deformity (ASD) surgery can fail in several ways, including clinical issues, radiographic problems, and reoperations. Understanding these failure modes is key to improving ASD treatment safety and cost-effectiveness.
Area of Science:
- Orthopedic Surgery
- Spinal Deformity Correction
- Adult Spinal Deformity (ASD)
Background:
- Adult spinal deformity (ASD) surgery offers significant benefits but is associated with high complication and failure rates.
- The complexity and volume of ASD surgeries are increasing, particularly in older patients with comorbidities.
- Despite potential improvements in pain and disability, ASD procedures carry risks of major complications and outright failure.
Purpose of the Study:
- To review and synthesize recent literature on treatment failure in adult spinal deformity (ASD).
- To identify and summarize strategies for preventing common failure modes in ASD surgery.
- To consolidate evidence on ASD failure phenotypes to guide future research and innovation.
Main Methods:
- A systematic literature search was conducted using the PubMed database.
- Articles focusing on failure after adult spinal deformity surgery were included.
- No institutional review board approval was required for this literature review.
Main Results:
- ASD surgery failure presents in four primary phenotypes: clinical failure, radiographic failure, need for reoperation, and lack of cost-effectiveness.
- Revision surgery rates for ASD remain high, impacting the overall cost-effectiveness of these interventions.
- Identifying and understanding these failure patterns is crucial for improving patient outcomes.
Conclusions:
- Consolidating evidence on ASD failure modes can stimulate research and innovation.
- Improving the safety and cost-effectiveness of ASD surgery is a primary goal.
- Further advancements are needed to mitigate the risks associated with adult spinal deformity treatments.
