Comparative Analysis of Clinical Outcomes and Complications in Patients With Degenerative Scoliosis Undergoing Primary Versus Revision Surgery

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Abstract

Study Design.

Retrospective cohort analysis of prospectively collected data.

Objective.

To compare clinical outcomes and postoperative complications in patients with lumbar degenerative scoliosis who underwent primary (P) versus revision (R) surgery.

Summary of Background Data.

Revision surgery for spinal deformity is technically challenging and may be associated with greater risks of complications and inferior clinical outcomes. There is a paucity of data in the literature comparing primary versus revision surgery in patients with degenerative scoliosis with respect to their clinical outcomes and complications.

Methods.

An analysis of 84 consecutive patients with degenerative scoliosis who underwent primary versus revision surgery between 2002 and 2010 with a minimum 2-year follow-up was performed.

Results.

There were 53 patients in the primary group and 31 in the revision group. The average number of previously operated levels in the revision group was 3.5 ± 2.6. Mean age at surgery, sex, and body mass index were similar between the 2 groups, as well as comorbidities and postoperative complication rates (P > 0.05). Although a greater preoperative coronal imbalance was noticed in the revision group (P: 2.5 cm vs. R: 4.8 cm, P = 0.022), the final radiographical measures were comparable between the 2 groups. At 2-year follow-up, Oswestry Disability Index and visual analogue scale scores improved significantly in both groups compared with preoperatively (P < 0.001). The improvement in scores of Oswestry Disability Index and visual analogue scale preoperatively to final follow-up was similar between the 2 groups (P > 0.05).

Conclusion.

Revision patients achieved the same radiographical and clinical outcomes as primary patients. The complication rates were similar between primary and revision patients. Revision patients benefit from surgery just as much as primary patients at 2-year follow-up.

Conclusion.

Level of Evidence: 3

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