Patient satisfaction after multiple revision surgeries for adult spinal deformity

Author:

Durand Wesley M.1,Daniels Alan H.2,DiSilvestro Kevin2,Lafage Renaud3,Diebo Bassel G.2,Passias Peter G.4,Kim Han Jo3,Protopsaltis Themistocles4,Lafage Virginie3,Smith Justin S.5,Shaffrey Christopher I.6,Gupta Munish C.7,Klineberg Eric O.8,Schwab Frank3,Gum Jeffrey L.9,Mundis Gregory M.10,Eastlack Robert K.10,Kebaish Khaled1,Soroceanu Alex11,Hostin Richard A.12,Burton Douglas13,Bess Shay14,Ames Christopher P.15,Hart Robert A.16,Hamilton D. Kojo17,_ _

Affiliation:

1. Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland;

2. Department of Orthopaedic Surgery, Brown University, Alpert Medical School, Providence, Rhode Island;

3. Department of Orthopaedic Surgery, Lenox Hill Hospital, New York;

4. Department of Orthopaedic Surgery, New York University, Langone Medical Center, New York, New York;

5. Department of Neurosurgery, University of Virginia Health System, Charlottesville, Virginia;

6. Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina;

7. Department of Orthopaedic Surgery, Washington University in St. Louis, Missouri;

8. Department of Orthopaedic Surgery, University of California, UC Davis Medical Center, Sacramento, California;

9. Department of Orthopaedic Surgery, Leatherman Spine Center, Louisville, Kentucky;

10. Department of Orthopaedic Surgery, San Diego Spine, La Jolla, California;

11. Department of Orthopaedic Surgery, University of Calgary, Alberta, Canada;

12. Department of Orthopaedic Surgery, Southwest Scoliosis Institute, Plano, Texas;

13. Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas;

14. Department of Orthopaedic Surgery, Denver International Spine Center, Denver, Colorado;

15. Department of Neurosurgery, University of California, San Francisco, California;

16. Department of Orthopaedic Surgery, Swedish Neuroscience Institute, Swedish Medical Center, Seattle, Washington; and

17. Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania

Abstract

OBJECTIVE Revision surgery is often necessary for adult spinal deformity (ASD) patients. Satisfaction with management is an important component of health-related quality of life. The authors hypothesized that patients who underwent multiple revision surgeries following ASD correction would exhibit lower self-reported satisfaction scores. METHODS This was a retrospective cohort study of 668 patients who underwent ASD surgery and were eligible for a minimum 2-year follow-up. Visits were stratified by occurrence prior to the index surgery (period 0), after the index surgery only (period 1), after the first revision only (period 2), and after the second revision only (period 3). Patients were further stratified by prior spine surgery before their index surgery. Scoliosis Research Society–22 (SRS-22r) health-related quality-of-life satisfaction subscore and total satisfaction scores were evaluated at all periods using multiple linear regression and adjustment for age, sex, and Charlson Comorbidity Index. RESULTS In total, 46.6% of the study patients had undergone prior spine surgery before their index surgery. The overall revision rate was 21.3%. Among patients with no spine surgery prior to the index surgery, SRS-22r satisfaction scores increased from period 0 to 1 (from 2.8 to 4.3, p < 0.0001), decreased after one revision from period 1 to 2 (4.3 to 3.9, p = 0.0004), and decreased further after a second revision from period 2 to 3 (3.9 to 3.3, p = 0.0437). Among patients with spine surgery prior to the index procedure, SRS-22r satisfaction increased from period 0 to 1 (2.8 to 4.2, p < 0.0001) and decreased from period 1 to 2 (4.2 to 3.8, p = 0.0011). No differences in follow-up time from last surgery were observed (all p > 0.3). Among patients with multiple revisions, 40% experienced rod fracture, 40% proximal junctional kyphosis, and 33% pseudarthrosis. CONCLUSIONS Among patients undergoing ASD surgery, revision surgery is associated with decreased satisfaction, and multiple revisions are associated with additive detriment to satisfaction among patients initially undergoing primary surgery. These findings have direct implications for preoperative patient counseling and establishment of postoperative expectations.

Publisher

Journal of Neurosurgery Publishing Group (JNSPG)

Subject

General Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3