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Does Prior Short‐Segment Surgery for Adult Scoliosis Impact Clinical Outcome among Patients Undergoing Scoliosis Correction?: E‐Poster #232

Smith, Justin S. MD, PhD; Shaffrey, Christopher I. MD; Carreon, Leah Y. MD, MSc; Glassman, Steven D. MD; Schwab, Frank J. MD; Lafage, Virginie C. PhD; Fu, Kai‐Ming MD, PhD; Berven, Sigurd H. MD; Bridwell, Keith H. MD

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Spine Journal Meeting Abstracts: 2010 - Volume - Issue - p 144
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Summary: This matched cohort study did not identify significant differences in complications rates or clinical outcome for adults with a history of prior short‐segment spine surgery who undergo more extensive scoliosis correction. Introduction: In many adults with scoliosis, symptoms may be referable to focal pathology, and may be addressed with short‐segment procedures. Our objective was to assess whether these “small fixes” impact surgical parameters and clinical outcomes for those who subsequently require more extensive scoliosis correction.

Methods: This is a matched cohort study based on a prospective multicentered deformity database. Inclusion criteria included: age>21, Cobb angle >20°, clinical outcomes measures at 2 or 3 yrs following scoliosis surgery. Patients with prior short‐segment (<5 levels) surgery were propensity matched to patients with no prior surgery based on age, Oswestry Disability Index (ODI), Cobb angle and sagittal balance (SB).

Results: Thirty matched pairs were identified. Among previously operated patients, 30% had prior instrumentation. 40% had prior arthrodesis, and the mean number of operated levels was 2.4 (SD=0.9). Previously operated patients had a trend toward greater blood loss and increased number of instrumented levels, but did not differ significantly based on complication rates, length of surgery, blood loss, or clinical outcome based on ODI, SRS‐22 or SF‐12 PCS (Table).

Conclusion: Compared with patients without a history of prior spine surgery, adult scoliosis patients with a history of prior short‐segment spine surgery who undergo more extensive scoliosis correction do not have significantly different complication rates or experience less clinical improvement.

© 2010 Lippincott Williams & Wilkins, Inc.