STUDY DESIGN: Retrospective case series.OBJECTIVE: The objective of this study was to review the overall prevalence of, and indications for, reoperations after the index spine fusion for idiopathic scoliosis at our center.SUMMARY OF BACKGROUND DATA: Spine fusions for idiopathic scoliosis are expected to be the final therapeutic intervention in management. In a recent publication in 2006, reoperations after index spine fusion for idiopathic scoliosis were reported in 12.9% of patients at a single institution (n = 1046).METHODS: A spinal deformity database search at our center identified all primary anterior, posterior, and circumferential spinal fusions performed for idiopathic scoliosis (1985-2003). A total of 1057 patients were identified whose mean age was 14.4 years (7-22 years) with minimum 2 year follow-up after index surgery. Study cohort consisted patients who underwent reoperation for any reason after index fusion procedure.RESULTS: Of the 1057 spinal fusions for idiopathic scoliosis, 41 (3.9%) underwent reoperation. Primary surgeries were: 11 anterior spinal fusions, 25 posterior spinal fusions, and 5 circumferential spinal fusions. Mean follow-up was 5.7 years (2-10.8). Forty-seven additional procedures were performed during 46 reoperations at an average of 26 months after index procedure (1 week-73 months). Of the 47 reoperations, 20 (43%) were revision spinal fusions (for pseudarthroses, uninstrumented curve progression or junctional kyphosis), 16 (34%) because of infections (5 acute, 11 chronic), 7 (15%) for implant removals due to pain and/or prominence (4 complete, 3 partial), 2 (4%) were revision of loosened implants, and 2 (4%) were elective thoracoplasties.CONCLUSION: This study documented a 3.9% overall reoperation rate at our medical center, a 3-fold lower reoperation rate than the previously reported 12.9%. The most common reoperations were for infections (34%), pseudarthroses (26%), and postoperative curve progression of the adjacent unfused spine (17%).
Adolescent Child