• Yuki Taniguchi, Tetsuya Ohara, Satoshi Suzuki, Kota Watanabe, Teppei Suzuki, Koki Uno, Toru Yamaguchi, Haruhisa Yanagida, Keita Nakayama, Toshiaki Kotani, Kei Watanabe, Toru Hirano, Takuya Yamamoto, Ichiro Kawamura, Ryo Sugawara, Katsushi Takeshita, Satoru Demura, Norihiro Oku, Tatsuya Sato, Kenta Fujiwara, Tsutomu Akazawa, Hideki Murakami, Kenichiro Kakutani, Yoshitaka Matsubayashi, and Noriaki Kawakami.
• Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan.
• Spine. 2021 Apr 15; 46 (8): E498E504E498-E504.

Study DesignA retrospective multicenter cohort study.ObjectiveThe aim of this study was to identify the incidence and risk factors for UPROR within minimum 2-year follow-up in primary definitive fusion for pediatric spinal deformity.Summary Of Background DataSeveral previous reports have elucidated the incidence of complications after pediatric scoliosis surgery; however, there has been no study that described the incidence and risk factors for unplanned return to the operating room (UPROR) with long-term follow-up in surgery for pediatric scoliosis with every etiology.MethodsWe retrospectively extracted data of patients aged <19 years, from 14 institutes in Japan, who underwent primary definitive fusion surgery for spinal deformity between January 1, 2015 and December 31, 2017. The primary outcomes were the incidence of UPROR within the minimum 2-year follow-up period for any reason. Univariate and multivariate logistical analyses were conducted to identify potential risk factors associated with UPROR.ResultsWe identified 1417 eligible patients (287 males and 1130 females) with a mean age of 13.9 years. UPROR for any reason within minimum 2-year follow-up was identified in 68 patients (4.8%). The most frequent cause for UPROR was implant failure found in 29 patients, followed by surgical site infection in 14 patients, junctional problems in 10 patients, and neurological complications in six patients. The multivariate logistic regression analysis revealed that a diagnosis of kyphosis (odds ratio [OR], 2.65; 95% confidence interval [CI] 1.16-6.04), etiology of congenital or structural type (OR 2.21; 95% CI 1.08-4.53), etiology of syndromic type (OR 2.67; 95% CI 1.27-5.64), and increased operation time of ≥300 minutes (OR 1.81; 95% CI 1.07-3.07) were the risk factors for the incidence of UPROR.ConclusionThe present multicenter study identified for the first time the incidence and risk factors for UPROR with minimum 2-year follow-up after primary definitive fusion surgery for pediatric spinal deformity with every etiology.Level of Evidence: 3.Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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