A retrospective multicenter cohort study.
To identify the incidence and risk factors for UPROR within minimum two-year follow-up in primary definitive fusion for pediatric spinal deformity.
Summary of Background Data.
Several previous reports have elucidated the incidence of complications after pediatric scoliosis surgery; however, there has been no study that described the incidence and risk factors for unplanned return to the operating room (UPROR) with long-term follow-up in surgery for pediatric scoliosis with every etiology.
We retrospectively extracted data of patients aged less than 19 years, from 14 institutes in Japan, who underwent primary definitive fusion surgery for spinal deformity between 1 January 2015 and 31 December 2017. The primary outcomes were the incidence of UPROR within the minimum two-year follow-up period for any reason. Univariate and multivariate logistical analyses were conducted to identify potential risk factors associated with UPROR.
We identified 1,417 eligible patients (287 males and 1,130 females) with a mean age of 13.9 years. UPROR for any reason within minimum two-year follow-up was identified in 68 patients (4.8%). The most frequent cause for UPROR was implant failure found in 29 patients, followed by surgical site infection in 14 patients, junctional problems in 10 patients, and neurological complications in six patients. The multivariate logistic regression analysis revealed that a diagnosis of kyphosis (odds ratio, 2.65; 95% confidence interval, 1.16–2.04), etiology of congenital or structural type (2.21; 1.08–4.53), etiology of syndromic type (2.67; 1.27–5.64), and increased operation time of 300 minutes or more (1.81; 1.07–3.07) were the risk factors for the incidence of UPROR.
The present multicenter study identified for the first time the incidence and risk factors for UPROR with minimum 2-year follow-up after primary definitive fusion surgery for pediatric spinal deformity with every etiology.
Level of Evidence: 3