DOS 2016

DOS Kongressen 2016 ·

Incidence of revision surgery following long fusions

using lumbar, lumbo-sacral fixation or iliac fixation in

adult scoliosis patients

Miao Wang, Cody Bünger, Abarajitha Thiyagarajah, Ming Sun, Ebbe Stender

Hansen, Haisheng Li, Kestutis Valancius, Peter Helmig, Kristian Høy

Department of spine surgery, Aarhus University Hospital

Background:

Adult scoliosis is a common disorder that is associated with sig-

nificant pain, and functional impairment. Surgical treatment can significantly re-

store the function and improve the quality of life. However, the choice of lowest

level of long fixation remains controversial for spine surgeons.

Purpose / Aim of Study:

The aim of this study is to investigate the surgical

outcome of iliac fixation and lumbosacral fixation in adult scoliosis patients.

Materials and Methods:

We retrieved 78 adult patients with scoliosis in

Aarhus University Hospital from March 2010 to May 2015. 63 female and 15

male patients. Average age is 64-year old. Pre- and postoperative X-ray and

the revision operation were examined. McNemar test was used to compare the

revision rate between two groups.

Findings / Results:

In the lumbosacral fixation group, the lowest level of initial

surgical fixation was selected as lumbar level (L4/L5) for 34 patients; sacrum

level for 9 patients. The iliac level was selected for 35 patients. In total of 17 re-

operations were performed. lumbar fixation group had 15 reoperations (15/34

pts, 44%). Sacrum fixation groups had 2 re-operations (2/9 pts, 22%). Iliac

fixation groups had no reoperation. The reoperation rate of lumbosacral group is

significant higher than iliac fixation group (p<.05). the 15 re- operated patients

from lumbar group underwent different fixation surgeries. 3 another level fixa-

tion, 4 sacrum and 8 iliac fixation. two re- operated did not undergo extended

surgery to level.

Conclusions:

Long fusion surgery ended at lumbar level has the highest revi-

sion rate. The lowest level was selected as iliac level for adult scoliosis has sig-

nificantly lower revision rate compared to lumbosacral level.

No conflicts of interest reported

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