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Eur Spine J. 2016 Aug;25(8):2612-21. doi: 10.1007/s00586-015-3787-3. Epub 2015 Feb 6.

Recovery following adult spinal deformity surgery: the effect of complications and reoperation in 149 patients with 2-year follow-up.

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Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, 676 N. St. Clair Street, Suite 2210, Chicago, IL, 60611, USA.
San Diego Center for Spinal Disorders, La Jolla, CA, USA.
Department of Orthopaedic Surgery, University of California, Davis, Sacramento, CA, USA.
Department of Orthopaedic Surgery, Oregon Health and Science University, Portland, OR, USA.
Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA.
Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas, KS, USA.
Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, USA.
Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA.
Rocky Mountain Hospital for Children, Denver, CO, USA.
Department of Neurosurgery, University of Virginia Health System, Charlottesville, VA, USA.



To identify the effect of complications and reoperation on the recovery process following adult spinal deformity (ASD) surgery by examining health-related quality of life (HRQOL) measures over time via an integrated health state analysis (IHS).


A retrospective review of a multicenter, prospective ASD database was conducted. Complication number, type, and need for reoperation (REOP) or not (NOREOP) were recorded. Patients were stratified as having no complication (NOCOMP), any complication (COMP), only minor complications (MINOR) and any major complications (MAJOR). HRQOL measures included Oswestry Disability Index (ODI), Short Form-36 (SF-36), and Scoliosis Research Society-22 (SRS22) at baseline, 6 weeks, 1 and 2 years postoperatively. All HRQOL scores were normalized to each patient's baseline scores and an IHS was then calculated.


149 patients were included. COMP, MINOR, and MAJOR had significantly lower normalized SRS mental scores at 1 and 2 years than NOCOMP (p < 0.05). REOP had significantly worse normalized 1 and 2 year mental component score (MCS), SRS mental, and total score than NOCOMP (p < 0.05). COMP, MINOR, and MAJOR all had significantly lower SRS mental IHSs than NOCOMP (p < 0.05). REOP had significantly lower IHSs for MCS and SRS satisfaction than NOREOP (p < 0.05). REOP had a significantly lower MCS and SRS mental IHS than NOCOMP (p < 0.05).


An IHS analysis suggests there was a significantly protracted mental recovery phase associated with patients that had at least one complication, as well as either a minor and major complication. The addition of a reoperation also adversely affected the mental recovery as well as overall satisfaction.


Adult spinal deformity; Area under the curve; Complications; HRQOL; Integrated health state; Reoperation

[Indexed for MEDLINE]

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