Erik Lewerenz, Sarthak Mohanty, Fthimnir M Hassan, Nathan J Lee, Justin K Scheer, Chun Wai Hung, Steven G Roth, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke
{"title":"早期再手术对成人畸形患者的长期疼痛和活动评分没有不利影响。","authors":"Erik Lewerenz, Sarthak Mohanty, Fthimnir M Hassan, Nathan J Lee, Justin K Scheer, Chun Wai Hung, Steven G Roth, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke","doi":"10.1007/s43390-025-01083-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.</p><p><strong>Methods: </strong>ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.</p><p><strong>Results: </strong>238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again.</p><p><strong>Conclusion: </strong>Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn't undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.</p>","PeriodicalId":21796,"journal":{"name":"Spine deformity","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early reoperations do not adversely affect long-term pain and activity scores in adult deformity patients.\",\"authors\":\"Erik Lewerenz, Sarthak Mohanty, Fthimnir M Hassan, Nathan J Lee, Justin K Scheer, Chun Wai Hung, Steven G Roth, Joseph M Lombardi, Zeeshan M Sardar, Ronald A Lehman, Lawrence G Lenke\",\"doi\":\"10.1007/s43390-025-01083-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.</p><p><strong>Methods: </strong>ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.</p><p><strong>Results: </strong>238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again.</p><p><strong>Conclusion: </strong>Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn't undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.</p>\",\"PeriodicalId\":21796,\"journal\":{\"name\":\"Spine deformity\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-04-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine deformity\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s43390-025-01083-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine deformity","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s43390-025-01083-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Early reoperations do not adversely affect long-term pain and activity scores in adult deformity patients.
Purpose: To compare patient-reported outcomes (PROs) in adult spinal deformity (ASD) patients reoperated within six months of their index surgery to patients without readmissions/reoperations and note any similarities/dissimilarities in activity and pain outcomes.
Methods: ASD patients who underwent spinal fusion at a single institution with minimum two years follow-up were included. Patients without readmissions/reoperations (No Reops) were compared to those requiring early reoperation resolved by six months post-index procedure (Early Reop) cohort. Outcomes included 2Y PROs, improvement, and MCID attainment. Question 22 from the SRS-22r, assessing likelihood of choosing the same treatment, was separately evaluated.
Results: 238 patients [211(89%) No Reops; 27(11%) Early Reop] were included. Early reoperations were associated with PJK/DJK (29.63%, n = 8), implant dislodgement (18.52%, n = 5), and pedicle/vertebral fracture (14.81%, n = 4). There was no difference in demographics, operative characteristics, baseline alignment, and preoperative PROs. PRO improvement was not significantly different for SRS Activity (p = 0.392), Pain (p = 0.291), Appearance (p = 0.179), Mental Health (p = 0.840), Satisfaction (p = 0.098), Total score (p = 0.152), and ODI (p = 0.564). MCID achievement was comparable for SRS Activity (p = 0.536), Pain (p = 0.115), Appearance (p = 0.269), Mental Health (p > 0.999), Satisfaction (p = 0.149), and ODI (p = 0.403). SRS total score MCID attainment was greater for No Reops Cohort (82% vs 70%, p = 0.048). In addition, a greater proportion of No Reop patients endorsed that they would choose the same operative management (86% vs 70%, p = 0.046) if they had to choose again.
Conclusion: Early reoperations within 6 months after ASD surgery that addresses the reason for the revision surgery do not adversely affect two-year functional and pain outcomes. However, only 70% would choose the same treatment again vs 86% of those who didn't undergo a reoperation with greater SRS22r total score MCID attainment among the No Reop cohort.
期刊介绍：
Spine Deformity the official journal of the?Scoliosis Research Society is a peer-refereed publication to disseminate knowledge on basic science and clinical research into the?etiology?biomechanics?treatment?methods and outcomes of all types of?spinal deformities. The international members of the Editorial Board provide a worldwide perspective for the journal's area of interest.The?journal?will enhance the mission of the Society which is to foster the optimal care of all patients with?spine?deformities worldwide. Articles published in?Spine Deformity?are Medline indexed in PubMed.? The journal publishes original articles in the form of clinical and basic research. Spine Deformity will only publish studies that have institutional review board (IRB) or similar ethics committee approval for human and animal studies and have strictly observed these guidelines. The minimum follow-up period for follow-up clinical studies is 24 months.
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