Similar clinical improvements seen for revision ASD surgery patients who had three operations

SAN DIEGO — Patients who underwent revision adult spinal deformity surgery and had three or more previous operations had higher rates of reoperation and complications; however, at mean 30-month follow-up, investigators found these patients had clinical improvements similar to patients who did not have as many previous operations.

Isador H. Lieberman, MD, MBA, FRCSC, and colleagues retrospectively collected data on 137 consecutive patients who had revision surgery for adult spinal deformity. Patients were classified into the following groups: 51 patients who underwent one previous operation (group 1); 45 patients who underwent two previous operations (group 2); and 41 patients who underwent three or more previous operations (group 3). Investigators reviewed perioperative complications 90 days after surgery and additional surgeries were reviewed at the most recent follow-up. Preoperatively and at the most recent follow-up, back pain VAS, leg pain VAS, Oswestry Disability Index scores and radiographic measurements were collected.

“Overall, group 3 had more complications than group 1 and group 2,” he said during his presentation. “Then we looked at the reoperation rates, and again, group 3 stands out [and] trends to more [reoperations].”

He added, “The net clinical improvement — this was interesting. VAS scores improved similarly across the board. Leg pain scores improved across the board, as did Oswestry disability. So, even though [patients] had three surgeries with me operating on them, I got them to improve as much as I got the group 2 and group 1 patients.”

Minor or major perioperative surgical complications and medical complications developed in 14 patients in group 1, 14 patients in the group 2 and 16 patients in group 3. Additional surgery was needed at a mean 30-months follow-up for four patients from group 1, eight patients from group 2 and nine patients in group 3. – by Monica Jaramillo

Reference:

Lieberman IH, et al. Paper #452. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 14-18, 2017; San Diego.

Disclosure: Lieberman reports he has stock or stock options in Bioniks Laboratories, is a paid consultant for Globus Medical, is a paid consultant for and has stock or stock options in Mazor Surgical Technologies, is a paid presenter or speaker for Misonix Inc. and is a paid consultant for Safe Orthopaedics and Stryker.