Radiographical and Implant-Related Complications in Adult @entity85 Surgery: Incidence, XXXX Risk Factors, and Impact on Health-Related Quality of Life.

@entity1 @entity532 @entity1515 @entity717 @entity85
STUDY DESIGN: A multicenter, prospective review of surgical @entity1 with adult @entity85 . OBJECTIVE: Assessment of the incidence, risk factor, and impact of @entity532 ( @entity532 ) on health-related quality of life measures. SUMMARY OF BACKGROUND DATA: This study provides assessment of the incidence of @entity532 in adult @entity85 surgery and impact of these complications on need for reoperation. Risk factors for development of @entity532 are also assessed, as well as the impact of these complications on health-related quality of life (HRQOL) outcomes measures. METHODS: A multicenter, prospective database of surgical @entity1 with adult @entity85 was reviewed. All @entity1 with complete 2-year follow-up were included. HRQOL was measured using the @entity717 Index, General Health Survey (36-Item Short Form Health Survey [SF-36]), and Scoliosis Research Society-22 (SRS-22r) at baseline, 6 weeks, 1 year, and 2 years postoperatively. Univariate testing was performed as appropriate. Multivariate logistic regression modeling was used to determine independent predictors of @entity532 . Multivariate repeated-measures mixed models were used to examine HRQOL, accounting for confounders. RESULTS: A total of 245 @entity1 met inclusion criteria. The incidence of @entity532 was 31.7% and 52.6% of those @entity1 required reoperation. Rod breakage accounted for 47% of the implant-related complications, and proximal junctional kyphosis accounted for 54.5% of radiographical complications. Univariate analysis identified the following potential risk factors for @entity532 : weight, American Society of Anesthesiologists score, revision, stopping the fusion in the lower thoracic spine, worse SRS-Schwab classification modifiers (pelvic tilt++, pelvic incidence minus @entity1515 ++, sagittal vertical axis++), higher T1 spinopelvic inclination, and higher T1 slope. Independent predictors of @entity532 as identified on multivariate logistic regression included American Society of Anesthesiologists (odds ratio: 1.75, P = 0.029) and sagittal vertical axis modifier ++ (odds ratio 3.43, P = 0.0001). The @entity532 and no @entity532 groups each experienced significant improvement over time, as measured on the @entity717 Index (P = 0.0001), SF-36 (P = 0.0001), and SRS-22r (P = 0.0001). However, the rate of improvement over time was less for @entity1 with @entity532 (SRS-22r P = 0.043, SF-36 P = 0.0001). CONCLUSION: This study identified that nearly one-third of @entity1 undergoing adult @entity85 surgery experienced a radiographical or implant-related complication, and that just more than one-half of these @entity1 experiencing complication required a reoperation within 2 years of surgery. These complications significantly affected HRQOL measures. Baseline @entity1 characteristics and parameters of the SRS-Schwab classification can be used to help identify those @entity1 at greater risk. LEVEL OF EVIDENCE: 3.
