Unanticipated revision surgery in adolescent idiopathic scoliosis.
METHODS
Retrospective case series.


OBJECTIVE
The objective of this study was to share our experience in the surgical treatment of adolescent idiopathic scoliosis (AIS), specifically the rate of revision surgeries and their indications.


BACKGROUND
Minimizing AIS surgical morbidity includes prevention of short- and long-term complications that could require an unanticipated revision. There have been an increasing number of reports about revision rates and their causes in AIS. This study summarizes the experience of a large patient population treated by a single surgeon in a single institution.


METHODS
All patients who underwent surgical treatment for AIS between 10 and 20 years of age during 1983 to 2005 were reviewed. All revision surgeries performed during the same period were searched. The indications for revision and type of procedure performed were recorded.


RESULTS
A total of 502 patients with AIS underwent spinal fusion with instrumentation at an average age of 14.3 years at initial surgery. In 485 patients, the surgery consisted of posterior-only spinal fusion. A total of 24 revision surgeries were performed for 23 patients (4.9%; cumulative probability of revision = 8%). The primary indications for revision were residual rib deformity (n = 8), instrumentation dislodgement (n = 4), compensatory curve progression (n = 3), junctional kyphosis (n = 3), and symptomatic implants (n = 3). One patient had a late infection. There was 1 case of pseudoarthrosis. One patient requested scar revision. There were no cases of neurological deficit.


CONCLUSIONS
In this single-surgeon series, revision after the index spinal fusion was required for a relatively low proportion of patients. The main indications for revision were residual rib deformity, hook dislodgment, and progression of the unfused compensatory curve.
Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA.
Mauricio
M
Campos
Lori
L
Dolan
Stuart
S
Weinstein
D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007738:Kyphosis / Q000453:epidemiology; D008297:Male; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000453:epidemiology; D055815:Young Adult