Complications following thoracolumbar spinal surgery for adult spinal deformity in the setting of rheumatoid arthritis with minimum 2-year follow-up surveillance
Source: PubMed Central Open Access, NCBI / U.S. National Library of Medicine
ABSTRACT Study Design: Retrospective cohort study. Objectives: Given its high and increasing prevalence in the United States, rheumatoid arthritis (RA) has been a growing area of focus for spine surgeons. The literature regarding the long-term outcomes of RA patients undergoing adult spinal deformity (ASD) surgery is limited. Thus, the purpose of this study was to compare the postoperative complications and revisions through 2 years postoperatively between patients with and without RA undergoing ASD surgery. Methods: A retrospective analysis of the New York Statewide Planning and Research Cooperative System database was performed. Patients undergoing spinal fusion for ASD were selected for and divided into two cohorts based on RA status. Univariate analysis compared demographics, complications, length of stay, and revisions between cohorts. Multivariate logistic regression models, adjusted for age, gender, number of levels fused, and Deyo score. Results: A total of 6020 patients were identified, of which 238 (3.9%) patients had RA. Patients with RA had a higher rate of total complications (61.3% RA+ vs. 44.0% RA−,< 0.001), surgical complications (24.4% RA+ vs. 15.6% RA−,< 0.001), medical complications (55.9% RA+ vs. 37.2% RA−,< 0.001), and revision (26.9% vs. 19.1,= 0.003). RA was identified as an independent predictor of both overall complications (OR: 1.7 [95% confidence interval: 1.2–2.3];= 0.001) and revision (odds ratio: 1.6 [CI: 1.05–2.5];= 0.03). Conclusion: This study
Abstract
ABSTRACT Study Design: Retrospective cohort study. Objectives: Given its high and increasing prevalence in the United States, rheumatoid arthritis (RA) has been a growing area of focus for spine surgeons. The literature regarding the long-term outcomes of RA patients undergoing adult spinal deformity (ASD) surgery is limited. Thus, the purpose of this study was to compare the postoperative complications and revisions through 2 years postoperatively between patients with and without RA undergoing ASD surgery. Methods: A retrospective analysis of the New York Statewide Planning and Research Cooperative System database was performed. Patients undergoing spinal fusion for ASD were selected for and divided into two cohorts based on RA status. Univariate analysis compared demographics, complications, length of stay, and revisions between cohorts. Multivariate logistic regression models, adjusted for age, gender, number of levels fused, and Deyo score. Results: A total of 6020 patients were identified, of which 238 (3.9%) patients had RA. Patients with RA had a higher rate of total complications (61.3% RA+ vs. 44.0% RA−,< 0.001), surgical complications (24.4% RA+ vs. 15.6% RA−,< 0.001), medical complications (55.9% RA+ vs. 37.2% RA−,< 0.001), and revision (26.9% vs. 19.1,= 0.003). RA was identified as an independent predictor of both overall complications (OR: 1.7 [95% confidence interval: 1.2–2.3];= 0.001) and revision (odds ratio: 1.6 [CI: 1.05–2.5];= 0.03). Conclusion: This study found RA to be an independent risk factor for increased complications and subsequent revision surgery after fusion surgery for ASD. Surgeons can use this data when counselling patients with RA regarding their operative risk.