alexa Revision Surgery After Three-Column Osteotomy in 335 Adult Spinal Deformity Patients: Inter-Center Variability and Risk Factors.
Neurology

Neurology

Journal of Spine

Author(s): Maier S, Smith JS, Schwab F, Obeid I, Mundis G,

Abstract Share this page

Abstract STRUCTURED ABSTRACT: Study Design. Multicenter, retrospective review.Objective. Assess rates, site variability, and risk factors for revision surgery (RS) following three-column osteotomy(3CO).Summary of Background Data. Complex spinal osteotomies, including 3CO, are being increasingly performed in the setting of adult spinal deformity (ASD) patients with sagittal plane deformity. 3CO procedures are associated with high complication and RS rates, but risk factors for complications and variability across centers for revision have not been well defined.Methods. The incidence and indications for RS in 335 ASD patients were analyzed. RS indications were classified as "mechanical"(MR: implant failure, pseudarthrosis, junctional failure, loss/lack of correction) or "non-mechanical"(NMR: neurologic deficit, infection, wound dehiscence, stenosis). Risks factors for RS were analyzed using generalized linear models.Results. Three-month and one-year RS incidences were 12.3\% and 17.6\%, respectively. Single-level 3CO (n = 311) had lower RS rates than multi-level 3CO(n = 24, 15.8\% vs. 41.7\%, p = 0.001). The 16.7\% rate for single-level lumbar 3CO included 11.4\% for MR and 5.7\% for NMR. For all RS, 50\% of MR and 78.6\% of NMR occurred within three-months of the index surgery. There was significant variation in rates across sites(range = 6.3\% to 31.9\%, p = 0.001), however low- and high-volume sites had similar rates(18.2\% vs. 16.2\%, p = 0.503). Patients with MR were more likely to be sagittaly under-corrected at three-months(SVA = 7cm vs 3.2cm, p = 0.003). Patients with NMR had more caudal 3CO levels (L4 vs L3, p = 0.014) and larger 3CO bone resections than patients who did not(34° vs 24.5°, p = 0.003).Conclusions. 3CO procedures for ASD surgery can provide significant deformity correction and lead to marked improvement in function despite established complication and revision rates. This study shows that RS is associated with lower level osteotomy and higher residual SVA. There is significant variability in revision rates across sites independent of site volume, suggesting potential systems and practice variations that warrant further study. This article was published in Spine (Phila Pa 1976) and referenced in Journal of Spine

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

  • 18th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    Nov 13-15, 2017, Athens, Greece
  • 2nd International Conference on Pediatric Neurology  
    August 31-September 01, 2017 Prague, Czech Republic
  • 12th Global Neurologists Annual Meeting on Neurology and Neurosurgery
    November 16-18, 2017 Lisbon, Portugal

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords