The Value of Plastic Surgery Closure in Adults Undergoing Scoliosis Surgery

Introduction: Surgical treatment for scoliosis can be done for functional and esthetic concerns. Surgical intervention may be associated with a complication rate of up to 40% in patients with non-idiopathic scoliosis, and 3% in patients with idiopathic scoliosis. In the present study, the authors sought to evaluate patients undergoing surgery for scoliosis with closure by the plastic and reconstructive surgery service. Methods: A retrospective cohort study was performed by extracting data, including demographics, surgical characteristics, and outcomes, from the electronic medical records of a single, large, tertiary care hospital and from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. Data was collected for patients aged 18 to 75 undergoing spinal surgery for scoliosis from 2012 to 2020. Data collected from institutional records included only patients whose incision was closed by plastic and reconstructive surgery, while data from NSQIP was collected from all scoliosis surgery patients regardless of closure type. Results: A total of 98 scoliosis patients were identified who underwent closure by the plastic and reconstructive surgery service. These were compared to 1390 scoliosis patients in NSQIP for whom no specific closure details were noted. At 30-day post-operatively, readmission rates were 2.04% and 7.34% for the institutional and NSQIP cohorts, respectively (P = 0.041), reoperation rates were 1.04% and 5.83% for the institutional and NSQIP cohorts, respectively (P = 0.0384), and overall complication rates were 2.04% and 12.52% for the institutional and NSQIP cohorts, respectively (P = 0.0005). Conclusion: Surgical intervention for scoliosis may benefit from closure by the plastic and reconstructive surgery service, which may yield potential lower rates of readmission, reoperation, and post-operative complication.