Revision Strategies for Harrington Rod Instrumentation : Radiographic Outcomes and Complications
STUDY DESIGN: Retrospective case series.
OBJECTIVE: The purpose of this study is to evaluate the clinical and radiographic outcomes following revision surgery following Harrington rod instrumentation.
METHODS: Patients who underwent revision surgery with a minimum of 1-year follow-up for flatback syndrome following Harrington rod instrumentation for adolescent idiopathic scoliosis were identified from a multicenter dataset. Baseline demographics and intraoperative information were obtained. Preoperative, initial postoperative, and most recent spinopelvic parameters were compared. Postoperative complications and reoperations were subsequently evaluated.
RESULTS: A total of 41 patients met the inclusion criteria with an average follow-up of 27.7 months. Overall, 14 patients (34.1%) underwent a combined anterior-posterior fusion, and 27 (65.9%) underwent an osteotomy for correction. Preoperatively, the most common lower instrumented vertebra (LIV) was at L3 and L4 (61%), whereas 85% had a LIV to the pelvis after revision. The mean preoperative pelvic incidence-lumbar lordosis mismatch and C7 sagittal vertical axis were 23.7° and 89.6 mm. This was corrected to 8.1° and 28.9 mm and maintained to 9.04° and 34.4 mm at latest follow-up. Complications included deep wound infection (12.2%), durotomy (14.6%), implant related failures (14.6%), and temporary neurologic deficits (22.0%). Eight patients underwent further revision surgery at an average of 7.4 months after initial revision.
CONCLUSIONS: There are multiple surgical techniques to address symptomatic flatback syndrome in patients with previous Harrington rod instrumentation for adolescent idiopathic scoliosis. At an average of 27.7 months follow-up, pelvic incidence-lumbar lordosis mismatch and C7 sagittal vertical axis can be successfully corrected and maintained. However, complication and reoperation rates remain high.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
|---|---|
| Enthalten in: |
Global spine journal - 12(2022), 4 vom: 16. Mai, Seite 654-662 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Louie, Philip K [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Adjacent segment degeneration |
|---|
| Anmerkungen: |
Date Revised 16.07.2022 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1177/2192568220960759 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM315711396 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM315711396 | ||
| 003 | DE-627 | ||
| 005 | 20231225155517.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2022 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/2192568220960759 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1052.xml |
| 035 | |a (DE-627)NLM315711396 | ||
| 035 | |a (NLM)33000651 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Louie, Philip K |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Revision Strategies for Harrington Rod Instrumentation |b Radiographic Outcomes and Complications |
| 264 | 1 | |c 2022 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 16.07.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a STUDY DESIGN: Retrospective case series | ||
| 520 | |a OBJECTIVE: The purpose of this study is to evaluate the clinical and radiographic outcomes following revision surgery following Harrington rod instrumentation | ||
| 520 | |a METHODS: Patients who underwent revision surgery with a minimum of 1-year follow-up for flatback syndrome following Harrington rod instrumentation for adolescent idiopathic scoliosis were identified from a multicenter dataset. Baseline demographics and intraoperative information were obtained. Preoperative, initial postoperative, and most recent spinopelvic parameters were compared. Postoperative complications and reoperations were subsequently evaluated | ||
| 520 | |a RESULTS: A total of 41 patients met the inclusion criteria with an average follow-up of 27.7 months. Overall, 14 patients (34.1%) underwent a combined anterior-posterior fusion, and 27 (65.9%) underwent an osteotomy for correction. Preoperatively, the most common lower instrumented vertebra (LIV) was at L3 and L4 (61%), whereas 85% had a LIV to the pelvis after revision. The mean preoperative pelvic incidence-lumbar lordosis mismatch and C7 sagittal vertical axis were 23.7° and 89.6 mm. This was corrected to 8.1° and 28.9 mm and maintained to 9.04° and 34.4 mm at latest follow-up. Complications included deep wound infection (12.2%), durotomy (14.6%), implant related failures (14.6%), and temporary neurologic deficits (22.0%). Eight patients underwent further revision surgery at an average of 7.4 months after initial revision | ||
| 520 | |a CONCLUSIONS: There are multiple surgical techniques to address symptomatic flatback syndrome in patients with previous Harrington rod instrumentation for adolescent idiopathic scoliosis. At an average of 27.7 months follow-up, pelvic incidence-lumbar lordosis mismatch and C7 sagittal vertical axis can be successfully corrected and maintained. However, complication and reoperation rates remain high | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a adjacent segment degeneration | |
| 650 | 4 | |a adult spinal deformity | |
| 650 | 4 | |a harrington rod instrumentation | |
| 650 | 4 | |a revision surgery | |
| 700 | 1 | |a Iyer, Sravisht |e verfasserin |4 aut | |
| 700 | 1 | |a Khanna, Krishn |e verfasserin |4 aut | |
| 700 | 1 | |a Harada, Garrett K |e verfasserin |4 aut | |
| 700 | 1 | |a Khalid, Alina |e verfasserin |4 aut | |
| 700 | 1 | |a Gupta, Munish |e verfasserin |4 aut | |
| 700 | 1 | |a Burton, Douglas |e verfasserin |4 aut | |
| 700 | 1 | |a Shaffrey, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Lafage, Renaud |e verfasserin |4 aut | |
| 700 | 1 | |a Lafage, Virginie |e verfasserin |4 aut | |
| 700 | 1 | |a Dewald, Christopher J |e verfasserin |4 aut | |
| 700 | 1 | |a Schwab, Frank J |e verfasserin |4 aut | |
| 700 | 1 | |a Kim, Han Jo |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Global spine journal |d 2011 |g 12(2022), 4 vom: 16. Mai, Seite 654-662 |w (DE-627)NLM233811001 |x 2192-5682 |7 nnns |
| 773 | 1 | 8 | |g volume:12 |g year:2022 |g number:4 |g day:16 |g month:05 |g pages:654-662 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/2192568220960759 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 12 |j 2022 |e 4 |b 16 |c 05 |h 654-662 | ||