• Omar Ramos, Jacob Razzouk, Eduardo Beauchamp, Benjamin Mueller, Eiman Shafa, Amir A Mehbod, Wayne Cheng, Olumide Danisa, and Bayard C Carlson.
• Twin Cities Spine Center, Minneapolis, MN.
• Spine. 2024 Jul 1; 49 (13): 916922916-922.

Study DesignRetrospective review of prospectively collected data.ObjectiveThe current study evaluates whether the addition of the Vertebral Bone Quality (VBQ) score to the Fusion Risk Score (FRS) improves its ability to predict perioperative outcomes.Summary Of Background DataThe FRS was developed to assess preoperative risk in patients undergoing thoracic and lumbar fusions. It includes patient-derived and surgical variables, but it does not include one that directly accounts for bone health. The VBQ score allows assessment of bone quality and has been shown to correlate to DEXA-measured bone mineral density (BMD) scores.MethodsThe VBQ score was weighted based on a regression model and then added to the FRS (FRS/VBQ). The ability of the two scores to predict the outcomes was then assessed using the area under the curve (AUC).Patient SamplePatients undergoing elective thoracic and lumbar spinal fusion from January 2019 to June 2020 were included.Outcome MeasuresThe study evaluated various perioperative adverse outcomes, including major and minor adverse events, discharge other than home, extended length of stay, 90-day emergency department visits, 90-day readmission, and 90-day and 2-year reoperation rates.ResultsA total of 353 met the inclusion and exclusion criteria. The FRS/VBQ demonstrated improved predictive ability compared with the FRS alone when evaluating 90-day reoperation. Both scores showed fair predictive ability for any adverse event, major adverse events, minor adverse events, and 2-year reoperation rates, with AUCs ranging from 0.700 to 0.737. Both had poor predictive ability for the other outcomes.ConclusionsAdding VBQ to the FRS significantly enhances its predictive accuracy for reoperation rate. This updated risk score provides a more comprehensive understanding of a patient's preoperative risk profile, aiding both patients and physicians in assessing surgical risks and optimizing outcomes through preoperative risk stratification.Level Of Evidence3.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

32 keywords...

hide…