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Are patients who return for 10-year follow-up after AIS surgery different from those who do not?

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Abstract

Purpose

To evaluate the impact of patients lost to follow-up on outcomes of surgery for adolescent idiopathic scoliosis (AIS) at 10-year postoperative.

Methods

Preoperative, 2-year, and 5-year postoperative demographic, radiographic, and SRS-22 data from a prospective multi-center registry were compared between patients with a 10-year follow-up visit versus those without. A second analysis utilized variables that were different between the groups, along with SRS scores, in a cohort of patients with preoperative, 2-, 5-, and 10-year postoperative SRS scores (complete cohort) to impute missing 10-year data (imputed cohort) utilizing Markov chain Monte Carlo simulation.

Results

250 patients had 10-year follow-up (21%). Those with 10-year follow-up had a greater percentage of patients who underwent anterior procedures (p < 0.05). Radiographically, the groups were similar at all three time points. SRS-22 scores demonstrated slightly worse pain and function preoperatively and at 2 year in those lost to follow-up (effect size eta = 0.11–0.12), with no differences at 5 year. Imputed data analysis demonstrated similar trends over time in SRS-22 scores compared to the complete cohort for total score and all domains except pain. There was no significant difference in imputed versus complete 10-year SRS-22 scores (p > 0.05).

Conclusion

This study identified early differences between patients with 10-year follow-up and those without, though effect sizes were small and non-existent at 5 years. SRS-22 scores at 10 year between the complete and imputed data sets did not differ. Clinically relevant outcomes of the subset who followed-up at 10 year are likely generalizable to the entire eligible AIS population.

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Acknowledgements

This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS imaging, Stryker Spine, Medtronic, NuVasive, Zimmer Biomet and the Food and Drug Administration. Harms Study Group Investigators: Aaron Buckland, MD; Royal Children’s Hospital—Melbourne Australia, Amer Samdani, MD; Shriners Hospitals for Children—Philadelphia, Amit Jain, MD; Johns Hopkins Hospital, Baron Lonner, MD; Mount Sinai Hospital, Benjamin Roye, MD; Columbia University, Burt Yaszay, MD; Rady Children’s Hospital, Chris Reilly, MD; BC Children’s Hospital, Daniel Hedequist, MD; Boston Children’s Hospital, Daniel Sucato, MD; Texas Scottish Rite Hospital, David Clements, MD; Cooper Bone & Joint Institute New Jersey, Firoz Miyanji, MD; BC Children’s Hospital, Harry Shufflebarger, MD; Paley Orthopedic & Spine Institute, Jack Flynn, MD; Children’s Hospital of Philadelphia, John Asghar, MD; Paley Orthopedic & Spine Institute, Jean Marc Mac Thiong, MD; CHU Sainte-Justine, Joshua Pahys, MD; Shriners Hospitals for Children—Philadelphia, Juergen Harms, MD; Klinikum Karlsbad-Langensteinbach, Karlsbad, Keith Bachmann, MD; University of Virginia, Lawrence Lenke, MD; Columbia University, Lori Karol, MD; Children’s Hospital, Denver Colorado, Mark Abel, MD; University of Virginia, Mark Erickson, MD; Children’s Hospital, Denver Colorado, Michael Glotzbecker, MD; Rainbow Children’s Hospital, Cleveland, Michael Kelly, MD; Washington University, Michael Vitale, MD; Columbia University, Michelle Marks, PT, MA; Setting Scoliosis Straight Foundation, Munish Gupta, MD; Washington University, Nicholas Fletcher, MD; Emory University, Noelle Larson, MD; Mayo Clinic Rochester Minnesota, Patrick Cahill, MD; Children’s Hospital of Philadelphia, Paul Sponseller, MD; Johns Hopkins Hospital, Peter Gabos, MD: Nemours/Alfred I. duPont Hospital for Children, Peter Newton, MD; Rady Children’s Hospital, Peter Sturm, MD; Cincinnati Children’s Hospital, Randal Betz, MD; Institute for Spine & Scoliosis, Stefan Parent, MD: CHU Sainte-Justine, Stephen George, MD; Nicklaus Children's Hospital, Steven Hwang, MD; Shriners Hospitals for Children—Philadelphia, Suken Shah, MD; Nemours/Alfred I. duPont Hospital for Children, Sumeet Garg, MD; Children’s Hospital, Denver Colorado, Tom Errico, MD; Nicklaus Children's Hospital, Vidyadhar Upasani, MD; Rady Children’s Hospital.

Funding

This study was supported in part by grants to the Setting Scoliosis Straight Foundation in support of Harms Study Group research from DePuy Synthes Spine, EOS imaging, Stryker Spine, Medtronic, NuVasive, Zimmer Biomet and the Food and Drug Administration.

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Authors and Affiliations

  1. Rady Children’s Hospital, 3030 Children’s Way, MC 5062, San Diego, CA, 92123, USA

    Tracey P. Bastrom, Roland Howard, Carrie E. Bartley, Peter O. Newton, Lawrence G. Lenke, Paul D. Sponseller, Harry Shufflebarger, Baron Lonner, Suken A. Shah, Randal Betz & Burt Yaszay

Authors
  1. Tracey P. Bastrom
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  2. Roland Howard
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  3. Carrie E. Bartley
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  4. Peter O. Newton
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  5. Lawrence G. Lenke
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  6. Paul D. Sponseller
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  7. Harry Shufflebarger
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  8. Baron Lonner
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  9. Suken A. Shah
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  10. Randal Betz
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  11. Burt Yaszay
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Contributions

RH: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. LL: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. PS: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. TB: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. CB: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. PON: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. HS: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. BL: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. SS: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. BY: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval. RB: design, data acquisition, analysis and/or interpretation of work, manuscript drafting and/or critically revising, final approval.

Corresponding author

Correspondence to Burt Yaszay.

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One or more of the authors reports funding to their institution related to the submitted work and financial relationships with entities outside of the submitted work. Details of which can be found in the individual author disclosure forms submitted with this manuscript.

Ethical approval

IRB approval was obtained for this study.

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Bastrom, T.P., Howard, R., Bartley, C.E. et al. Are patients who return for 10-year follow-up after AIS surgery different from those who do not?. Spine Deform 10, 527–535 (2022). https://doi.org/10.1007/s43390-021-00458-5

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  • DOI: https://doi.org/10.1007/s43390-021-00458-5

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