A Risk Quantification Reference Table for Progressed Adolescent Idiopathic Scoliosis Surgery: An Exact Case Matched Outcomes Analysis
Study Design Retrospective Exact Matched case-control study Objectives Surgical treatment delay in AIS due to family preferences is common. This study aims to quantify the increase in risks as the Cobb angle increases and provide a Quantifiable Risk Reference Table that can be utilized for counselin...
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Veröffentlicht in: | Global spine journal 2023-10, Vol.13 (8), p.2228-2238 |
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Format: | Artikel |
Sprache: | eng |
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Zusammenfassung: | Study Design
Retrospective Exact Matched case-control study
Objectives
Surgical treatment delay in AIS due to family preferences is common. This study aims to quantify the increase in risks as the Cobb angle increases and provide a Quantifiable Risk Reference Table that can be utilized for counseling.
Methodology
AIS patients were divided into 3 groups: Group A: Cobb angle 50–60°, Group 61–70°, and Group CFinal ≥80°. Each patient in Group CFinal who had curve progression were then traced-back-in-time (TBIT) to review the clinical data at earlier presentations at 50–60° (C1), and 61–70° (C2). Patient demographics, radiological, operative, and outcomes data were compared between Group A vs C1 and Group B vs Group C2.
Results
A total of 614 AIS surgeries were reviewed. Utilizing the EM technique, a total of 302 AIS patients were recruited. There were 147, 111, 31, and 32 patients matched in Groups A, B, C1, and C2, respectively. C2 Final patients had 34% curve pattern change, 23.2% higher incidence of requiring two surgeries, and 17.3% increase in complications. There was a statistically significant increase of 2.4 spinal levels fused, 12% increase in implant density, 35% increase in operative time, 97% increase in intra-operative blood loss, 10% loss of scoliosis correction, 40% longer hospitalization stay, and 36% increase in costs for patients who had curve progression.
Conclusion
This study is the first to use a homogenously matched AIS cohort to provide a Quantifiable Risk Reference Table. The Risk Table provides essential knowledge for treating physicians when counseling AIS patients. |
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ISSN: | 2192-5682 2192-5690 |
DOI: | 10.1177/21925682221079262 |