Patient satisfaction after multiple revision surgeries for adult spinal deformity

التفاصيل البيبلوغرافية
العنوان: Patient satisfaction after multiple revision surgeries for adult spinal deformity
المؤلفون: Wesley M. Durand, Alan H. Daniels, Kevin DiSilvestro, Renaud Lafage, Bassel G. Diebo, Peter G. Passias, Han Jo Kim, Themistocles Protopsaltis, Virginie Lafage, Justin S. Smith, Christopher I. Shaffrey, Munish C. Gupta, Eric O. Klineberg, Frank Schwab, Jeffrey L. Gum, Gregory M. Mundis, Robert K. Eastlack, Khaled Kebaish, Alex Soroceanu, Richard A. Hostin, Douglas Burton, Shay Bess, Christopher P. Ames, Robert A. Hart, D. Kojo Hamilton
المصدر: Journal of Neurosurgery: Spine. 38:75-83
بيانات النشر: Journal of Neurosurgery Publishing Group (JNSPG), 2023.
سنة النشر: 2023
مصطلحات موضوعية: General Medicine
الوصف: 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.
تدمد: 1547-5654
DOI: 10.3171/2022.6.spine2273
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::6cbe5b299a9a24f3173eaa5ea243d6b7
https://doi.org/10.3171/2022.6.spine2273
رقم الانضمام: edsair.doi.dedup.....6cbe5b299a9a24f3173eaa5ea243d6b7
قاعدة البيانات: OpenAIRE
الوصف
تدمد:15475654
DOI:10.3171/2022.6.spine2273