Your browser doesn't support javascript.
loading
What if You Could Treat the Same Patient Again, Would You do the Exact Same Spine Surgery? A Multi-Surgeon Survey of Their Own Revisions.
Sheehan, Connor; Mohamed, Ayman; Schwab, Frank; Burton, Douglas; Okonkwo, David; Eastlack, Robert; Kim, Han J; Klineberg, Eric; Hamilton, KoJo; Bess, Shay; Lafage, Renaud; Lafage, Virginie.
Afiliación
  • Sheehan C; Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
  • Mohamed A; Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
  • Schwab F; Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
  • Burton D; Department of Orthopedic Surgery, University of Kansas Medical Center, Kansas City, KS, USA.
  • Okonkwo D; Department of Neurological Surgery, University of PittsburghMedical Center, Pittsburgh, PA, USA.
  • Eastlack R; San Diego Center for Spinal Disorders, La Jolla, CA, USA.
  • Kim HJ; Department of Spine Surgery, Hospital for Special Surgery, New York, NY, USA.
  • Klineberg E; Department of Orthopedic surgery, University of Texas Health, Houston, TX, USA.
  • Hamilton K; Department of Neurological Surgery, University of PittsburghMedical Center, Pittsburgh, PA, USA.
  • Bess S; Department of Orthopedic Surgery, Denver International Spine Center/Presbyterian St. Luke's Medical Center, Denver, CO, USA.
  • Lafage R; Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
  • Lafage V; Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Health, New York, NY, USA.
Global Spine J ; : 21925682241286445, 2024 Sep 18.
Article en En | MEDLINE | ID: mdl-39293466
ABSTRACT
STUDY

DESIGN:

Case-based survey.

OBJECTIVES:

This study aims to investigate what a group of surgeons learned from their own revisions, and what they would do differently today.

METHODS:

A multi-center database of ASD surgical patients was queried to identify those with at least 2 surgical procedures performed by the same surgeon between 2009 and 2019. A clinical vignette was created for each case including demographics, a timeline of events, radiographs/measurements, patient-reported outcomes, complications, and surgical strategies used for the index and revision surgeries. The operative surgeon was then asked to fill out a five-question survey aimed at determining factors that contribute to operative decision-making and planning.

RESULTS:

86 patients were operated on by 6 participating surgeons for both index and revision ASD surgery. The revised patients had similar follow-up compared to the non-revised group (P = 0.73), with the most common complications indicating a need for revision surgery being proximal junctional failure (42%) and pseudoarthrosis (28%). Surgeons reported that they would not change their surgical strategy in 52.3% of the cases. The leading cause for revision was hardware/instrumentation issues (24.4%). Learning points included rod-related choice (23.3%), level selection (19.8), PJF prophylactic strategy (15.1%), and sagittal alignment objective (11.6%).

CONCLUSIONS:

Surgeons saw opportunity in nearly half of the cases to improve outcomes by changing something in the original surgery. While 40% of the failures remained unexplained from the surgeons' perspective, this study highlights the capacity for adopting changes in adult spinal deformity surgery and illuminates the reasoning behind certain surgical decisions.
Palabras clave
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Global Spine J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Global Spine J Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido