One-year Postoperative Radiographic and Patient-reported Outcomes Following Cervical Deformity Correction Are Not Affected by a Short-term Unplanned Return to the OR

Abstract

Study Design. Retrospective analysis of a prospectively collected multicenter database. Objective. The objective of this study was to assess the radiographic and health-related quality of life (HRQoL) impact of a short-term (<1 y) return to the operating room (OR) after adult cervical spine deformity (ACSD) surgery. Summary of Background Data. Returns to the OR within a year of ACSD correction can be particularly devastating to these vulnerable hosts as they often involve compromise of the soft tissue envelope, neurological deficits, or hardware failure. This work sought to assess the impact of a short-term reoperation on 1-year radiographic and HRQoL outcomes. Materials and Methods. Patients operated on from January 1, 2013, to January 1, 2019, with at least 1 year of follow-up were included. The primary outcome was a short-term return to the OR. Variables of interest included patient demographics, Charlson Comorbidity Index, HRQoL measured with the modified Japanese Orthopaedic Association), Neck Disability Index, and EuroQuol-5D Visual Analog Scale (EQ-5D VAS) and radiographic outcomes, including T1 slope, C2–C7 sagittal Cobb angle, T1 slope–Cobb angle, and cervical sagittal vertical axis. Comparisons between those who did versus did not require a 1-year reoperation were performed using paired t tests. A Kaplan-Meier survival curve was used to estimate reoperation-free survival up to 2 years postoperatively. Results. A total of 121 patients were included in this work (age: 61.9±10.1 yr, body mass index: 28.4±6.9, Charlson Comorbidity Index: 1.0±1.4, 62.8% female). A 1-year unplanned return to the OR was required for 28 (23.1%) patients, of whom 19 followed up for at least 1 year. Indications for a return to the OR were most commonly for neurological complications (5%), infectious/wound complications (5.8%), and junctional failure (6.6%) No differences in demographics, comorbidities, preoperative or 1-year postoperative HRQoL, or radiographic outcomes were seen between operative groups. Conclusion. Reoperation <1 year after ACSD surgery did not influence 1-year radiographic outcomes or HRQoL.