Study Design: Epidemiological study.
Purpose: To establish the revision rate of adult spinal deformity surgery.
Summary Of Background Data: Historically, surgical treatment of adult spinal deformity was limited by inadequate correction and high complication rates. More recently, improved techniques have produced more consistent clinical benefit. However, the need for revision surgery remains a persistent and inadequately defined problem.
Methods: Patients who had multilevel spinal fusion for adult spinal deformity were identified from a national insurance database containing private payer and Medicare records using International Classification of Diseases, Ninth Revision or Current Procedural Terminology codes from 2005 to 2011. Revision procedures were identified based on codes for spinal instrumentation and fusion.
Results: The Medicare sample included 1,879 patients (1,329 females and 550 males). The revision rate in this cohort was 6% in Year 1 postoperatively, 6% in Year 2, 4% in Year 3, and 3% in Year 4, for a cumulative 19% revision rate. In the private payer database, 803 patients (559 females and 244 males) were identified. Revision rate was 10% in Year 1 postoperatively, 3% in Year 2, 2% in Year 3, and 1% in Year 4, for a cumulative 16% revision rate. Pooling the databases yielded an overall 18% revision rate at 4 years postoperatively. Fewer revisions were noted at 1 year postoperatively in the Medicare sample and the 1-year revision rate was inversely proportional to age across the entire cohort. The revision rate equalized across age groups over time such that no differences were seen at 4 years postoperatively.
Conclusions: The value of an intervention depends on efficacy, safety, and durability. Despite improvements in technique and clinical outcome, an 18% revision rate at 4 years postoperatively is not sustainable from either a clinical or an economic standpoint. This study establishes a benchmark for the critical effort that is needed to reduce the revision rate in adult spinal deformity surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jspd.2014.08.005 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Hip Fractures in Malta: Does Delay in Surgery Affect Clinical Outcomes?
Cureus
December 2024
Surgery, Mater Dei Hospital, Msida, MLT.
Introduction: Hip fractures are common and are a major cause of significant morbidity and mortality in the elderly population, particularly when treatment is delayed. The British Orthopaedic Association's (BOA) guidelines state that surgical treatment should be performed within 36 hours of admission. This study aimed to investigate the effects of delays in surgery on clinical outcomes and to evaluate mortality rates over a three-year follow-up period following proximal femoral fractures.
View Article and Find Full Text PDFStem fixation techniques in revision total knee arthroplasty: A systematic review and meta-analysis.
J Exp Orthop
January 2025
Department of Orthopaedic Surgery and Traumatology Città della Salute e della Scienza Turin Italy.
Purpose: This systematic review and meta-analysis aimed to compare the clinical and radiological outcomes of patients undergoing revision total knee arthroplasty (rTKA) using uncemented press-fit stems (hybrid fixation) versus cemented stems (cemented fixation). It is also examined whether cemented fixation offers any superiority over hybrid fixation regarding implant survival, clinical function, imaging analysis and complication rates.
Methods: Following the PRISMA guidelines, a systematic review and meta-analysis were conducted on five databases (Pubmed, Scopus, Embase, Medline and Cochrane).
Effects of EGFR-TKIs combined with intracranial radiotherapy in EGFR-mutant non-small cell lung cancer patients with brain metastases: a retrospective multi-institutional analysis.
Radiat Oncol
January 2025
Department of Oncology, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong District, Chongqing, 400010, China.
Background: Patients with non-small cell lung cancer (NSCLC) are prone to developing brain metastases (BMs), particularly those with epidermal growth factor receptor (EGFR) mutations. In clinical practice, treatment-naïve EGFR-mutant NSCLC patients with asymptomatic BMs tend to choose EGFR-tyrosine kinase inhibitors (TKIs) as first-line therapy and defer intracranial radiotherapy (RT). However, the effectiveness of upfront intracranial RT remains unclear.
View Article and Find Full Text PDFThe effects of dance on maternal childbirth: a systematic review and meta-analysis.
BMC Pregnancy Childbirth
January 2025
School of Nursing, Chongqing Medical University, Chongqing, 400016, China.
Background: Previous guidelines have clearly stated that dance is safe and beneficial during pregnancy and for childbirth. However, due to the small sample size of individual studies and different interventions, there were inconsistencies about the effect of dance on maternal childbirth.
Methods: We included studies evaluating the effect of dance on women in labor.
Open Latarjet Results in Lower Recurrent Instability and Revision Rates Than Arthroscopic Bankart Repair at 10-Year Follow-up: A Systematic Review.
Arthroscopy
January 2025
Department of Orthopaedic Surgery, Duke University, Durham, North Carolina, USA. Electronic address:
Purpose: To compare arthroscopic Bankart repair versus the open Latarjet procedure at a minimum of 10-year follow-up evaluating recurrence and arthropathy development rates.
Methods: A systematic review was performed in concordance with PRISMA guidelines. Studies were included if they reported on the arthroscopic Bankart repair or open Latarjet procedure with a minimum of 10-year follow-up.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!