Saudi patients outcomes after surgical treatment of adolescent idiopathic scoliosis.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: No potential conflict of interest relevant to this article was reported. 9. Spine Deform. 2024 Mar;12(2):383-390. doi: 10.1007/s43390-023-00778-8. Epub 2023 Dec 13. Who gets staged surgery in severe pediatric and adolescent spine deformity? LaValva SM(1)(2), Swarup I(3), Garg S(4), Yaszay B(5), Gupta MC(6), Sucato DJ(7), Kelly MP(6), Samdani A(8), Lenke L(9), Boachie O(10), Cahill PJ(11)(12); Fox Study Group. Author information: (1)Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, HUB Building, 4th floor, 3500 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA. (2)Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. (3)UCSF Benioff Children's Hospital Oakland-Pediatric Orthopaedics, San Francisco, CA, USA. (4)Children's Hospital Colorado, Aurora, CO, USA. (5)Seattle Children's Hospital, Seattle, WA, USA. (6)Washington University School of Medicine, Saint Louis, MO, USA. (7)Texas Scottish Rite Hospital, Dallas, TX, USA. (8)Shriners Hospital for Children, Philadelphia, PA, USA. (9)Columbia University Orthopedic Surgery, New York, NY, USA. (10)Foundation of Orthopedics and Complex Spine (FOCOS), Pantang, Ghana. (11)Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, HUB Building, 4th floor, 3500 Civic Center Blvd., Philadelphia, PA, 19104-4399, USA. cahillp1@chop.edu. (12)Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA. cahillp1@chop.edu. BACKGROUND: There is significant debate regarding the indications of staged surgery for severe adolescent spinal deformity, and the factors associated with the decision to perform staged compared to same-day surgery have not been previously investigated. Thus, the purpose of this study was to determine which factors were most strongly associated with this decision. METHODS: A prospective multicenter registry of adolescent patients with severe spinal deformity was reviewed. Two cohorts were identified: those who underwent a planned staged surgical procedure for deformity correction and those who underwent a same-day procedure. Patients who underwent an unplanned staged procedure secondary to complications during the initial procedure were excluded. Comparisons were made between these cohorts with respect to preoperative patient and radiographic variables to determine which factors were associated with the decision to perform a staged procedure. Surgical data was also compared to evaluate for differences in the intraoperative management of staged versus same-day patients. RESULTS: Two hundred and twenty-nine patients with severe spinal deformities were identified. Forty patients (17%) underwent a planned staged procedure and 189 patients (80%) underwent a same-day procedure. On univariate analysis of preoperative variables, patients who underwent staged surgery had a significantly younger age at surgery, greater major curve magnitude, greater major curve AVT to CSVL, lesser thoracic spine height, greater radiographic trunk shift, and a greater proportion of patients undergoing revision surgery (as opposed to primary correction) compared to those who underwent a planned single-stage procedure. Multivariate logistic regression of pre-operative variables showed that age