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Adult Spinal Deformity Surgery Revision Rates Likely Low

Reasons for reoperation were predictable in both cause and time during study's follow-up period

THURSDAY, Jan. 21 (HealthDay News) -- In patients undergoing definitive spinal instrumented fusion for primary adult deformity, the revision rate may be relatively low, according to a study published in the Jan. 15 issue of Spine.

Mark A. Pichelmann, M.D., of the Washington University School of Medicine in St. Louis, and colleagues studied 643 surgical patients, including 432 with adult idiopathic scoliosis, 104 with de novo degenerative scoliosis, 63 with adult kyphotic disease, and 45 with neuromuscular scoliosis.

After a mean follow-up of 4.7 years for the entire cohort, the researchers found that 58 patients (9 percent) underwent at least one revision surgery and that the mean time to the first revision was four years. They also found that pseudarthrosis, curve progression, infection, and painful/prominent implants were the most common reasons for revision.

"The rate of unanticipated revision surgery for adult deformity was low at 9.0 percent, but can obviously only increase with longer follow-up periods," the authors conclude. "The reasons for reoperation were predictable in both cause and time during the follow-up period. They included pseudarthrosis particularly in the first five years and curve progression/adjacent segment degeneration typically later in follow-up. Long-term follow-up of at least five to 15 years is essential to assess the true outcome from adult deformity surgery."

This study was supported by corporate/industry funds, with one or more of the authors reporting financial relationships with a commercial party related directly or indirectly to the subject of the manuscript.

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