title: Outcome of Revision Surgery in Pediatric Spine Deformity Patients.
abstract: METHODS
  Retrospective case series.
  
  
  OBJECTIVE
  To report the complications and outcomes of pediatric revision spine surgery and review the surgical indications and treatment methods.
  Recent reports have shown the necessity of revision spine surgery for pediatric deformities. Many reports have shown the result of revision surgery for pediatric spinal deformity.
  
  
  METHODS
  We conducted a retrospective review of 638 patients with pediatric spinal deformity who were treated with surgery from 1996 to 2007. We identified 50 patients who underwent revision spinal fusion surgery with a minimum of 3 years of follow-up.
  
  
  RESULTS
  Mean follow-up was 4 years (range, 3-8.3 years). The diagnosis at index surgery was idiopathic scoliosis in 18 patients, congenital scoliosis in 13, neuromuscular scoliosis in 13, tumor and spinal arteriovenous malformation in 4, burst fracture in thoracic spine in 1, and Scheuermann kyphosis in 1. The primary surgeries were 1 hemi epiphysiodesis, 3 anterior spinal fusions, 4 posterior decompressions, 8 combined anterior and posterior spinal fusions, and 34 posterior spinal fusions. A total of 16 patients had pseudarthrosis, 12 decompensation, 11 progressive kyphosis, 8 crankshaft phenomenon, 2 infections, and 1 junctional degeneration. All 50 reoperations included spinal instrumentation and fusion. The revision surgeries were 2 anterior spinal fusions, 14 posterior fusions, and 34 combined anterior and posterior spinal fusions. Spine arthrodesis was obtained in 98% of patients (49 of 50) and complications occurred in 14% of patients (7 of 50). The Scoliosis Research Society Patient Questionnaire outcomes at the latest follow-up were as follows: total 3.95, function 3.88, pain 3.83, self-image 3.98, and mental health 4.04.
  
  
  CONCLUSIONS
  Pseudarthrosis was the most common indication for revision surgery, and bony union was achieved in 98% with revision surgery. Despite the complications, pediatric revision spine surgery can achieve successful outcomes.
authors.affiliation: Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA; National Hospital Organization Murayama Medical Center, 2-37-1 Musashi Murayama, Tokyo, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yagi
authors.affiliation: Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA.
authors.forename: Akilah B
authors.initials: AB
authors.lastname: King
authors.affiliation: Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA.
authors.forename: Han Jo
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Cunningham
authors.affiliation: Department of Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, 535 East 70th Street New York, NY 10021, USA. Electronic address: boachie@hss.edu.
authors.forename: Oheneba
authors.initials: O
authors.lastname: Boachie-Adjei
keywords: Complication; Crankshaft; Deformity; Revision surgery; Scoliosis