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Marfan syndrome and adolescent idiopathic scoliosis patients have similar 90-day postoperative outcomes and 5-year reoperation rates after spinal deformity surgery

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Abstract

Purpose

Outcomes after spinal deformity surgery in patients with Marfan syndrome (MFS) are poorly characterized given the rarity of the condition. Updated analyses from nationally representative samples, and comparison to outcomes after more commonly performed procedures for conditions such as adolescent idiopathic scoliosis (AIS) could help define the relative risks.

Methods

Using the 2010–2020 PearlDiver administrative databases, patients who underwent posterior spinal fusion for > 7 segments were extracted. MFS patients were matched 1:4 to AIS patients based on age, sex, and Elixhauer comorbidity index (ECI). Ninety-day outcomes and 5-year reoperation rates were compared. Significance was set at p < 0.05.

Results

In total, 206 MFS patients were matched to 825 AIS patients. After adjusting for age, sex, and ECI, multivariate odds ratios (OR) for 90-day any, serious, and minor adverse events, as well as readmissions, were not significantly different for those with MFS compared to those with AIS (p > 0.05 for each). Five-year reoperation rates were also not significantly different (13.1% for the MFS cohort and 13.0% for the AIS cohort (no difference by log-rank, p = 0.9).

Conclusion

While deformity surgery is much less commonly performed for MFS than AIS, it is not uncommonly considered for patients with this condition. Despite some known technical challenges for MFS deformity surgery, the current study leveraged a large, national database to find that 90-day adverse events and 5-year reoperations were not different for matched MFS and AIS patients undergoing deformity surgery. For select patients, these findings should be useful for surgical planning and patient counseling.

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Availability of data and material

All data is available from the national insurance claims database, PearlDiver MSpine.

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Funding

No funds, grants, or other support were received for this study.

Author information

Authors and Affiliations

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

    Peter Y. Joo, Dennis L. Caruana, Michael J. Gouzoulis, Harold G. Moore, Justin R. Zhu, Bijan Ameri & Jonathan N. Grauer

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  1. Peter Y. Joo
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  2. Dennis L. Caruana
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  3. Michael J. Gouzoulis
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  4. Harold G. Moore
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  5. Justin R. Zhu
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  6. Bijan Ameri
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  7. Jonathan N. Grauer
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Contributions

All authors meet the required criteria for authorship. PYJ: Material preparation, data analysis, writing-original draft preparation, edited manuscript drafts, approval of final version of manuscript, agree to be accountable for the work. DLC: Conceptualization, methodology, writing-original draft preparation, edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work. MJG: Conceptualization, methodology, writing-original draft preparation, edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work. HGM: Conceptualization, methodology, writing-original draft preparation, edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work. JRZ: Conceptualization, methodology, writing-original draft preparation, edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work. BA: Edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work. JNG: Conceptualization, methodology, edited manuscript draft preparation, approval of final version of manuscript, agree to be accountable for the work, supervision.

Corresponding author

Correspondence to Jonathan N. Grauer.

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Conflicts of interest

The authors declare they have no financial interests. Author JG is on the board of directors of NASS and LSRS and receives no compensation as member of the board of directors.

Code availability

All codes used were either from pre-existing codes from the PearlDiver software or custom-made directly in the software. Codes are available on request.

Ethics approval

This study was deemed exempt from Institutional Review Board review.

Informed consent

Informed consent was not required as the data analyzed was from a deidentified database.

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Joo, P.Y., Caruana, D.L., Gouzoulis, M.J. et al. Marfan syndrome and adolescent idiopathic scoliosis patients have similar 90-day postoperative outcomes and 5-year reoperation rates after spinal deformity surgery. Spine Deform 10, 1169–1174 (2022). https://doi.org/10.1007/s43390-022-00501-z

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  • DOI: https://doi.org/10.1007/s43390-022-00501-z

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