Early reoperations do not adversely affect long-term pain and activity scores in adult deformity patients

Erik Lewerenz, Sarthak Mohanty, Fthimnir M. Hassan, Nathan J. Lee, Justin K. Scheer, Chun Wai Hung, Steven G. Roth, Joseph M. Lombardi, Zeeshan M. Sardar, Ronald A. Lehman, Lawrence G. Lenke

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes. Methods: ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated. Results: 238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again. Conclusion: Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn’t undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.

Original languageEnglish (US)
JournalSpine Deformity
Early online dateApr 3 2025
DOIs
StateE-pub ahead of print - Apr 3 2025

Keywords

  • Adult spinal deformity
  • Minimal clinically important difference
  • Patient-reported outcomes
  • Postoperative outcomes
  • Reoperations
  • Satisfaction

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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