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Osteoarthritis is not associated with higher complication or revision surgery rates following spinal fusion for thoracolumbar scoliosis.
Osteoarthritis (OA) does not appear to increase peri-operative risk or worsen clinical outcomes in patients undergoing thoracolumbar scoliosis correction with spinal fusion, according to a retrospective study analyzing surgical and postoperative outcomes in more than 500 patients.
Luke Mugge and colleagues analyzed data from a prospectively maintained registry of patients who underwent spinal fusion procedures across all spinal levels. The analysis included 532 patients, of whom 192 had comorbid OA. The OA cohort differed considerably in baseline characteristics. Patients with arthritis were older, had a higher body mass index, and were more likely to be former smokers when compared with patients without arthritis.
Despite these differences, OA was not associated with higher rates of surgical complications or poorer recovery outcomes. During surgery, those with arthritis required longer spinal fusion constructs, with an average construct length of 6.55 compared with 5.79 in the non-arthritis group (P=0.0112). However, investigators found no prominent differences in intra-operative complication rates between the groups.
Postoperative outcomes were also comparable. The incidence of surgical site infection was same between the study groups (P=0.89). Similarly, the incidence of venous thrombotic events remained equivalent across both cohorts (P=1). Follow-up analysis depicted no significant rise in instrumentation failure among those with arthritis (P=0.11). The need for revision fusion surgery was also similar between groups (P=0.32).
Multivariable analysis reinforced the primary findings, showing consistent results for intra-operative variables as well as postoperative complications and long-term surgical outcomes. Although the investigators noted increased intra-operative blood loss in the OA cohort, they noted that the difference did not appear to have meaningful clinical consequences.
The study suggests that OA, despite being a common degenerative inflammatory condition in patients undergoing spinal procedures, should not be considered an independent predictor of peri-operative complications, instrumentation failure, or revision surgery following thoracolumbar scoliosis correction and spinal fusion.
Current Orthopaedic Practice
Osteoarthritis is not a peri-operative risk factor or indicator of poor clinical outcomes with surgical correction for thoracolumbar scoliosis
Luke Mugge et al.
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