Purpose

To evaluate the incidence and risk factors associated with the unplanned return to OR in EOS.

Methods

Medical records of 51 patients of EOS operated at three different centres using various types of GSCs were evaluated for complications requiring unplanned surgeries. Data were analysed to find out rate of unplanned surgeries in relation to the aetiology, age and Cobb angle at index surgery, type of implant, cause of unplanned surgery, and management required.

Results

Out of 51 patients, three did not meet inclusion criteria. Forty-eight patients of EOS operated by GSCs with a mean age of 6.7 years (range 2–12 years) with an average follow-up of 67.3 months were studied. There were 30 congenital, 10 idiopathic, 4 syndromic, and 4 neuromuscular cases. Thirty-nine out of 48 patients had one or more unplanned surgeries on follow-up (81.25%). Out of total 248 surgeries following index procedure, 82 were unplanned surgeries (33.06%), including 53 implant revisions, 12 implant-removal, 14 debridement, and 2 flaps. The common complications were 24.14% rod/screw breakage, 42.53% anchor pull-out, 16.09% infections, 6.90% wound dehiscence, and 4.6% neuro deficits. Unplanned surgeries were significantly higher in syndromic (58.8%) and neuromuscular (52.9%) than congenital (27.2%) and idiopathic (37.8%) cases (p < 0.05). Age at index procedure < 5 years had higher unplanned surgeries than age > 5 years (2.5 and 1.23 per patient, respectively, p < 0.05). Type of implant and initial Cobb angle did not significantly affect the rate of unplanned surgeries (p  > 0.05)

Conclusion

GSCs in EOS require a frequent revisit to operation room which should be well understood by the surgeon and parents.

中文翻译：

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在早发性脊柱侧弯 (EOS) 中脊柱结构 (GSC) 增长后意外返回手术室 (OR) - 一项多中心研究。

目的

评估与 EOS 中意外返回 OR 相关的发生率和风险因素。

方法

对在三个不同中心使用各种类型 GSC 进行手术的 51 名 EOS 患者的医疗记录进行了评估，以了解需要计划外手术的并发症。对数据进行分析以找出与索引手术时的病因、年龄和 Cobb 角、植入物类型、计划外手术的原因和所需管理有关的计划外手术率。

结果

在 51 名患者中，有 3 名不符合纳入标准。研究了 48 名由 GSC 手术的 EOS 患者，平均年龄为 6.7 岁（范围 2-12 岁），平均随访时间为 67.3 个月。先天性30例，特发性10例，综合征4例，神经肌肉4例。48 名患者中有 39 名在随访中进行了一次或多次计划外手术（81.25%）。在索引手术后的总共 248 次手术中，82 次是计划外手术 (33.06%)，包括 53 次种植体翻修、12 次种植体移除、14 次清创和 2 个皮瓣。常见的并发症是 24.14% 的杆/螺钉断裂、42.53% 的锚钉拔出、16.09% 的感染、6.90% 的伤口裂开和 4.6% 的神经功能缺损。综合征 (58.8%) 和神经肌肉 (52.9%) 的计划外手术明显高于先天性 (27.2%) 和特发性 (37.8%) 病例。p  < 0.05)。开始手术时年龄 < 5 岁的计划外手术率高于年龄 > 5 岁（每位患者分别为 2.5 和 1.23，p  < 0.05）。种植体类型和初始 Cobb 角对计划外手术率没有显着影响 ( p   > 0.05)

结论

EOS 中的 GSC 需要经常重新访问手术室，外科医生和父母应该很好地理解这一点。