{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T10:04:44Z","timestamp":1779530684922,"version":"3.53.1"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,12]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Adult spinal deformity (ASD) develops in the setting of asymmetrical arthritic degeneration, and can also be due to iatrogenic causes, such as prior surgery. Many patients who present with ASD have undergone prior spine surgery with instrumentation. Unfortunately, contemporary studies that evaluate the effect of prior surgery or instrumentation on perioperative outcomes, readmission rates, and need for reoperation are lacking.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n All ASD patients who underwent a 3-column osteotomy performed by the senior author at the authors\u2019 institution for correction of thoracolumbar spinal deformity between 2006 and 2016 were identified. The authors compared surgical outcomes between primary (first-time) and revision cases. Further subgroup analysis was conducted to investigate the effect of the number of prior surgeries (0, 1, 2, 3, 4, and 5 or more) and the presence of spinal instrumentation on outcomes. Multivariate analysis was used to adjust for relevant and significant confounders.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 300 patients were included; 38.3% of patients were male. The overall perioperative complication rate was 24.7%, and the mean length of hospitalization was 8.2 days. The 90-day readmission rate was 9.0%, and the overall follow-up reoperation rate was 26.7%. There were no significant differences in complication rates (26.6% vs 24.0%, p = 0.645), length of hospitalization (8.7 vs 7.9 days, p = 0.229), readmission rates (11.4% vs 8.1%, p = 0.387), or reoperation rates (26.6% vs 26.7%, p = 0.984) between primary and revision cases. There was no significant difference in wound complications (infections\/dehiscence) requiring reoperation (5.1% vs 6.3%, p = 0.683). Subgroup analysis conducted to evaluate the effect of the number of prior spinal surgeries or the presence of spinal instrumentation did not reveal significant differences for the aforementioned surgical outcomes. In adjusted multivariate analysis, there were no significant associations between history of prior surgery (number of prior surgeries and prior instrumentation) and all of the surgical outcomes of interest.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The findings from this study suggest that patients who have undergone prior spine surgery with or without instrumentation are not at increased risk for perioperative complications, need for readmission, or reoperation following 3-column osteotomy of the thoracolumbar spine.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.8.focus17460","type":"journal-article","created":{"date-parts":[[2017,12,1]],"date-time":"2017-12-01T03:36:31Z","timestamp":1512099391000},"page":"E8","source":"Crossref","is-referenced-by-count":6,"title":["Does prior spine surgery or instrumentation affect surgical outcomes following 3-column osteotomy for correction of thoracolumbar deformities?"],"prefix":"10.3171","volume":"43","author":[{"given":"Darryl","family":"Lau","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew K.","family":"Chan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedat","family":"Deverin","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Ames","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Spine (Phila Pa 1976)","first-page":"1198","article-title":"Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures","volume":"37","author":"Auerbach JD","year":"2012","unstructured":"Auerbach JD, Lenke LG, Bridwell KH, Sehn JK, Milby AH, Bumpass D, : Major complications and comparison between 3-column osteotomy techniques in 105 consecutive spinal deformity procedures. Spine (Phila Pa 1976) 37:1198\u20131210, 2012"},{"key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"235","article-title":"Can we safely reduce blood loss during lumbar pedicle subtraction osteotomy procedures using tranexamic acid or aprotinin? A comparative study with controls","volume":"35","author":"Baldus CR","year":"2010","unstructured":"Baldus CR, Bridwell KH, Lenke LG, Okubadejo GO: Can we safely reduce blood loss during lumbar pedicle subtraction osteotomy procedures using tranexamic acid or aprotinin? A comparative study with controls. Spine (Phila Pa 1976) 35:235\u2013239, 2010"},{"issue":"5","key":"b3","series-title":"Neurosurg Focus","first-page":"E18","article-title":"Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients","volume":"36","author":"Bianco K","year":"2014","unstructured":"Bianco K, Norton R, Schwab F, Smith JS, Klineberg E, Obeid I, : Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients. Neurosurg Focus 36(5):E18, 2014"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"E35","article-title":"Revision spinal fusion in patients older than 75: is it worth the risks?","volume":"39","author":"Chang MS","year":"2014","unstructured":"Chang MS, Chang YH, Revella J, Crandall DG: Revision spinal fusion in patients older than 75: is it worth the risks? Spine (Phila Pa 1976) 39:E35\u2013E39, 2014"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"393","article-title":"Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery","volume":"37","author":"Cho SK","year":"2012","unstructured":"Cho SK, Bridwell KH, Lenke LG, Cho W, Zebala LP, Pahys JM, : Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. Spine (Phila Pa 1976) 37:393\u2013401, 2012"},{"key":"b6","series-title":"Spine (Phila Pa 1976)","first-page":"1674","article-title":"Primary versus revision surgery in the setting of adult spinal deformity: a nationwide study on 10,912 patients","volume":"40","author":"Diebo BG","year":"2015","unstructured":"Diebo BG, Passias PG, Marascalchi BJ, Jalai CM, Worley NJ, Errico TJ, : Primary versus revision surgery in the setting of adult spinal deformity: a nationwide study on 10,912 patients. 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Spine (Phila Pa 1976) 36:958\u2013964, 2011"},{"key":"b26","series-title":"J Neurosurg Spine","first-page":"444","article-title":"Complication rates associated with 3-column osteotomy in 82 adult spinal deformity patients: retrospective review of a prospectively collected multicenter consecutive series with 2-year follow-up","volume":"27","author":"Smith JS","year":"2017","unstructured":"Smith JS, Shaffrey CI, Klineberg E, Lafage V, Schwab F, Lafage R, : Complication rates associated with 3-column osteotomy in 82 adult spinal deformity patients: retrospective review of a prospectively collected multicenter consecutive series with 2-year follow-up. 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A comparative study with controls","volume":"35","author":"Baldus CR","year":"2010","unstructured":"Baldus CR, Bridwell KH, Lenke LG, Okubadejo GO: Can we safely reduce blood loss during lumbar pedicle subtraction osteotomy procedures using tranexamic acid or aprotinin? A comparative study with controls. Spine (Phila Pa 1976) 35:235\u2013239, 2010"},{"issue":"5","key":"b3","series-title":"Neurosurg Focus","first-page":"E18","article-title":"Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients","volume":"36","author":"Bianco K","year":"2014","unstructured":"Bianco K, Norton R, Schwab F, Smith JS, Klineberg E, Obeid I, : Complications and intercenter variability of three-column osteotomies for spinal deformity surgery: a retrospective review of 423 patients. Neurosurg Focus 36(5):E18, 2014"},{"key":"b4","series-title":"Spine (Phila Pa 1976)","first-page":"E35","article-title":"Revision spinal fusion in patients older than 75: is it worth the risks?","volume":"39","author":"Chang MS","year":"2014","unstructured":"Chang MS, Chang YH, Revella J, Crandall DG: Revision spinal fusion in patients older than 75: is it worth the risks? Spine (Phila Pa 1976) 39:E35\u2013E39, 2014"},{"key":"b5","series-title":"Spine (Phila Pa 1976)","first-page":"393","article-title":"Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery","volume":"37","author":"Cho SK","year":"2012","unstructured":"Cho SK, Bridwell KH, Lenke LG, Cho W, Zebala LP, Pahys JM, : Comparative analysis of clinical outcome and complications in primary versus revision adult scoliosis surgery. 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J Neurosurg Spine 22:540\u2013553, 2015"},{"key":"b21","series-title":"Neurosurgery","first-page":"112","article-title":"The Comprehensive Anatomical Spinal Osteotomy Classification","volume":"74","author":"Schwab F","year":"2014","unstructured":"Schwab F, Blondel B, Chay E, Demakakos J, Lenke L, Tropiano P, : The Comprehensive Anatomical Spinal Osteotomy Classification. Neurosurgery 74:112\u2013120, 2014"},{"key":"b22","series-title":"Spine (Phila Pa 1976)","first-page":"E803","article-title":"Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis","volume":"38","author":"Schwab FJ","year":"2013","unstructured":"Schwab FJ, Blondel B, Bess S, Hostin R, Shaffrey CI, Smith JS, : Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. 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