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Thirty-Day Reoperation and Readmission Rates After Correction of Adult Spinal Deformity via Circumferential Minimally Invasive Surgeryd—Analysis of a 7-Year Experience

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Abstract

Study design

Single-center retrospective analysis of consecutive patients who have undergone circumferential minimally invasive surgery (cMIS) for correction of adult spinal deformity (ASD).

Objectives

To study the rates of reoperations and readmissions within the first 30 days following cMIS for correction of ASD.

Background

Hospital readmission and reoperation rates have been emphasized as an important measure of quality and cost-effectiveness of care. However, there is little information about the readmission rates following cMIS correction of ASD.

Methods

This is a retrospective cohort study of 214 consecutive patients with ASD who underwent correction using cMIS involving at least 2 levels. Major complications encountered during surgery or within 30 days following the index procedure that needed reoperation or readmission were recorded. The primary outcomes measured were early readmission, and early reoperation.

Results

An average of 4 levels were fused. Nineteen complications were noted in the 30-day period following the index surgery, giving an early complication rate of 8.9%. Twelve of those complications occurred during the initial hospitalization and 7 complications occurred after the patient had been discharged home. Forty-seven percent of the complications occurred within the first 3 years of our experience, 37% in the next 2 years, and only 16% in the following 3 years. The 30-day readmission rate was 3.3%, which showed no statistically significant difference based on the number of levels fused.

Conclusions

Our study delivers significant evidence that efforts to reduce hospital readmissions for ASD patients should begin by concentrating on the postoperative complications. Although minimally invasive approaches will not eliminate all complications, they may have an effect on reducing the rate of major complications, most notably the rate of postoperative infection. This in turn can lead to a substantially lower readmission and reoperation rate as is reported in our study.

Level of Evidence

Level IV, case series.

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Author information

Authors and Affiliations

  1. Department of Surgery, Spine Center, Cedars Sinai Medical Center, 444 South San Vicente Boulevard, Suite 800, Los Angeles, CA, 90048, USA

    Neel Anand MD, Zeeshan M. Sardar MD, Andrea Simmonds MD, Babak Khandehroo MD & Sheila Kahwaty PA-C

  2. Department of Neurosurgery, Cedars Sinai Medical Center, 444 South San Vicente Boulevard, Suite 800, Los Angeles, CA, 90048, USA

    Eli M. Baron MD

Authors
  1. Neel Anand MD
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  2. Zeeshan M. Sardar MD
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  3. Andrea Simmonds MD
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  4. Babak Khandehroo MD
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  5. Sheila Kahwaty PA-C
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  6. Eli M. Baron MD
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Corresponding author

Correspondence to Neel Anand MD.

Additional information

Author disclosures: NA (reports personal fees from Medtronics, personal fees from Medtronics, personal fees from Nuvasive, personal fees from Globus Medical, personal fees from Globus Medical, personal fees from Baxano Surgical, other from Globus Medical, during the conduct of the study; personal fees from Paradigm Spine, outside the submitted work); ZMS (none); AS (none); BK (none); SK (none); EMB (none).

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Anand, N., Sardar, Z.M., Simmonds, A. et al. Thirty-Day Reoperation and Readmission Rates After Correction of Adult Spinal Deformity via Circumferential Minimally Invasive Surgeryd—Analysis of a 7-Year Experience. Spine Deform 4, 78–83 (2016). https://doi.org/10.1016/j.jspd.2015.08.002

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  • DOI: https://doi.org/10.1016/j.jspd.2015.08.002

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