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A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”?

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Abstract

Purpose

Posterior scoliosis fusion (PSF) for adolescent idiopathic scoliosis (AIS) is considered a highly successful surgery with excellent outcomes. However, especially as many patients “graduate” from their pediatric surgeons, there is the need to quantify the long-term outcomes of such surgeries.

Methods

The 2010–2022 Pearldiver M161 dataset was queried for those who were 10 to 18 years old with AIS undergoing PSF with at least 10 years follow-up. Patient characteristics were abstracted. Reoperations were identified based on coding for any subsequent thoracic/lumbar surgery/revision. The 10-year reoperation rate and reasons for reoperation were determined, and multivariate regression was performed to determine risk factors.

Results

In total, 3,373 AIS PSF patients were identified. Of the study cohort, 324 (9.6%) underwent reoperation within 10-years with an interquartile range for timing of surgery of 81–658 days, of which 29.6% were done for infection. Reoperations were done within the first three months for 152 (46.9% of reoperations), three months to 2 years for 97 (29.9%), and 2 years to 10 years for 74 (22.8%). Based on multivariate regression, need for reoperation was associated with male sex (OR: 1.70), asthma (OR: 1.36) and greater than thirteen segments of instrumentation (OR: 1.48) (p < 0.05 for each) but not age, other comorbidities, or insurance.

Conclusions

The current study of a large national AIS PSF population found 9.6% to undergo reoperation in the 10 years following their index operation. Although specifics about the curve pattern could not be determined, the reoperation incidence and correlation with specific risk factors are notable and important for patient counselling.

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Data availability

All data were obtained from the publicly available Pearldiver dataset.

Code availability

Code is available is on request.

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Funding

MJG: received funding from James G. Hirsch Medical Student Fellowship at Yale University School of Medicine.

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Authors and Affiliations

  1. Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Street, 208071, New Haven, CT, 06510, USA

    Michael J. Gouzoulis, Peter Y. Joo, Seongho Jeong, Sahir S. Jabbouri, Jay Moran, Justin R. Zhu & Jonathan N. Grauer

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  1. Michael J. Gouzoulis
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  2. Peter Y. Joo
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  4. Sahir S. Jabbouri
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  6. Justin R. Zhu
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Contributions

Each author met requirements for authorship. MJG: Conceptualization, methodology, data acquisition, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. PYJ: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. SJ: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. SSJ: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. JM: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. JRZ: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work. JNG: Conceptualization, methodology, data analysis, writing/editing original manuscript, approval of manuscript, agree to be accountable for the work, Supervision.

Corresponding author

Correspondence to Jonathan N. Grauer.

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Conflict of interest

MJG: James G. Hirsch Medical Student Fellowship at Yale University School of Medicine, Associate Editor For North American Spine Society Journal; PYJ: No disclosures; SJ: No disclosures; SSJ: No disclosures; JM: No disclosures; JRZ: No disclosures; JNG: Editor in Chief of North American Spine Society Journal, Board Member of North American Spine Society.

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Includes appropriate approvals or waivers: Our Institutional Review Board has determined this study to be exempt from requiring review.

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Gouzoulis, M.J., Joo, P.Y., Jeong, S. et al. A 10-year perspective on the question of whether surgeries for adolescent idiopathic scoliosis are “one and done”?. Spine Deform (2024). https://doi.org/10.1007/s43390-024-00858-3

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