title: Unplanned return to the operating room in patients with adolescent idiopathic scoliosis: are we doing better with pedicle screws?
abstract: METHODS
  Prospective, longitudinal cohort.
  
  
  OBJECTIVE
  To evaluate the incidence, timing, and risk factors for reoperation in patients with adolescent idiopathic scoliosis (AIS) treated with pedicle screws (PSs) compared with hybrid (Hb) constructs.
  
  
  BACKGROUND
  Rates of return to the operating room (OR) after definitive fusion for AIS vary, with a paucity of data on PS constructs.
  
  
  METHODS
  A prospective multicenter database was retrospectively queried to identify consecutive patients with AIS who underwent posterior spinal fusion with either PS or Hb constructs with a minimum 2-year follow-up. All reoperations were stratified into an early group (<60 d) or a late group (>60 d). Univariate and multivariate logistical analyses were performed to identify potential risk factors related to reoperation.
  
  
  RESULTS
  A total of 627 patients met the inclusion criteria (PS = 540, Hb = 87). There was a statistically significant difference in the rate of reoperations between the PS (3.5%) and Hb groups (12.6%), P < 0.001. Early return to the OR occurred in 2.0% of the patients with PS compared with 3.4% in the Hb group, P = 0.43. Late returns to the OR occurred in 1.5% of PS group versus 9.2% of the Hb group, P < 0.001. Multivariate analysis revealed longer operating time as an independent risk factor for an unplanned return to the OR in patients treated with PSs (P < 0.05).
  
  
  CONCLUSIONS
  Our results suggest that patients with AIS treated with PS have decreased rates of unplanned return to the OR when compared with patients with Hb constructs. The majority of returns to the OR were early (<60 d) for the PS group compared with late (>60 d) for the Hb group. Longer operative times increased the risk of unplanned reoperation for the PS group.
  
  
  METHODS
  3.
authors.affiliation: *Shriners Hospitals for Children, Philadelphia, PA †Rady Children's Hospital, San Diego, CA ‡British Columbia Children's Hospital, Vancouver, BC, Canada §Miami Children's Hospital, Miami, FL; and ¶NYU Hospital for Joint Diseases, New York, NY.
authors.forename: Amer F
authors.initials: AF
authors.lastname: Samdani
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Belin
authors.forename: James T
authors.initials: JT
authors.lastname: Bennett
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Pahys
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Marks
authors.forename: Firoz
authors.initials: F
authors.lastname: Miyanji
authors.forename: Harry L
authors.initials: HL
authors.lastname: Shufflebarger
authors.forename: Baron S
authors.initials: BS
authors.lastname: Lonner
authors.forename: Peter O
authors.initials: PO
authors.lastname: Newton
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cahill
mesh_terms: D000293:Adolescent; D001863:Bone Screws; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009873:Operating Rooms / Q000706:statistics & numerical data; D011446:Prospective Studies; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012600:Scoliosis / Q000601:surgery*; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors