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Repeat surgical interventions following “definitive” instrumentation and fusion for idiopathic scoliosis: a 30-year update

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Abstract

Purpose

Although spinal fusion (SF) is considered “definitive” treatment in juvenile/adolescent idiopathic scoliosis (JIS/AIS), complications requiring reoperation continue to occur. The purpose of this study was to characterize the evolving rates of reoperation following SF in JIS/AIS.

Methods

Single-center retrospective review of patients who underwent SF for JIS/AIS as their index surgical treatment between 2013 and 2019. Patient data were collected to identify complications requiring reoperation and factors associated with reoperation. Complication rates from 2013 to 2019 were compared to patients from 1988 to 2012 at the same institution.

Results

This study analyzed 934 patients (81.7% female, mean age at surgery 14.5 ± 2.1). Thirty-eight patients (4.1%) required a total of 47 reoperations, a > 50% decrease in overall complication rate from the 2008–2012 population (4.1% vs 9.6%, respectively, p < 0.001). The decrease stemmed mainly from decreases in rates of infection (1.1% vs 4.1%, p < 0.001) and symptomatic implants (0.4% vs 2.1%, p = 0.004). There were, however, non-significant increases in implant failures (0.6% vs 0.2%, p = 0.4367) and pseudoarthrosis (1.0% vs 0.4%, p = 0.5202). Both of these complications were associated with patients with a higher mean weight (implant failure: 70.4 kg ± 21.1 vs 56.1 kg ± 14.9, p = 0.002; pseudoarthrosis: 85.8 kg ± 27.9 vs 55.9 ± 14.5, p = 0.001).

Conclusions

Reoperation following SF for JIS/AIS has decreased over the past 7 years when compared to 25 years of historical controls. The changing landscape of reoperation demands further research into the risk factors for those reoperations that have become more common.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. University of Texas Southwestern, Dallas, TX, USA

    Adam A. Jamnik & Sahiti D. Patibandla

  2. Scottish Rite for Children, Dallas, TX, USA

    Anne-Marie Datcu, Emily Lachmann, David Thornberg, Chan-hee Jo, William Z. Morris, Brandon Ramo & Megan Johnson

Authors
  1. Adam A. Jamnik
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  2. Anne-Marie Datcu
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  3. Emily Lachmann
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  4. Sahiti D. Patibandla
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  5. David Thornberg
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  6. Chan-hee Jo
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  7. William Z. Morris
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  8. Brandon Ramo
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  9. Megan Johnson
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Contributions

AJ: study design, data analysis, data interpretation, manuscript drafting, manuscript approval, and accountable. A-MD, EL, SP, and DT: study design, data analysis, data interpretation, manuscript approval, and accountable. C-hJ: data analysis, data interpretation, manuscript approval, and accountable. WM: study design, data analysis, data interpretation, manuscript approval, and accountable. BR, MJ: study design, data analysis, data interpretation, manuscript editing, manuscript approval, and accountable.

Corresponding author

Correspondence to Megan Johnson.

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Conflict of interest

All authors report no competing interests to disclose.

Ethical approval

Approval was granted for this study by our institution’s IRB, UT Southwestern.

Consent to participate

Informed consent was obtained from all participants and/or their parents/guardians. Assent was obtained for patients with the ability who were greater than 10 and less than 18 years of age.

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Participants signed informed consents which include information with regards to publish their data.

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Jamnik, A.A., Datcu, AM., Lachmann, E. et al. Repeat surgical interventions following “definitive” instrumentation and fusion for idiopathic scoliosis: a 30-year update. Spine Deform 12, 99–107 (2024). https://doi.org/10.1007/s43390-023-00742-6

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  • DOI: https://doi.org/10.1007/s43390-023-00742-6

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