{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:07:16Z","timestamp":1788516436133,"version":"build-2803163510"},"reference-count":16,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"\nOBJECTIVE <\/jats:title>\nAn aberrant inflammatory response, which plays a role in the development of postoperative complications, is observed in autoimmune diseases, Yet, there is a paucity of literature regarding the effects of autoimmune diseases after adult spinal deformity (ASD) surgery. The goal of this study was to determine the effects of autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus) on postoperative medical complications, patient-reported outcome measures (PROMs), and radiographic alignment in patients who underwent ASD surgery.<\/jats:p>\n<\/jats:sec>\n\nMETHODS<\/jats:title>\nPropensity-score matching for age and sex was performed for patients with autoimmune disease (group A) and nonautoimmune patients (group NA1). Postoperative medical complications, preoperative and 2-year follow-up PROMs, and preoperative, immediate postoperative, and 2-year follow-up radiographic alignment were evaluated.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nAmong 386 patients (27 in group A and 359 in group NA1), autoimmune patients had a higher incidence of respiratory complications (11.1% vs 2.2%, p = 0.036), gastrointestinal complications (14.8% vs 3.1%, p = 0.016), urinary tract infections (14.8% vs 3.1%, p = 0.016), cholecystitis (7.4% vs 0%, p = 0.005), and fever of unknown origin (14.8% vs 0%, p < 0.001). Autoimmune patients had worse preoperative ODI (54.2 vs 44.7, p = 0.004) and 2-year follow-up Scoliosis Research Society 22-item Questionnaire (SRS-22) scores (3.1 vs 3.5, p = 0.039), with higher preoperative sacral slope (23.4\u00b0 vs 17.8\u00b0, p = 0.020). Propensity-score matching for age and sex yielded 27 pairs (group A and group NA2). Having at least one medical complication (group A 74.1% vs group NA2 22.2%, p < 0.001), total complications per person (1.3 vs 0.3, p = 0.010), prognostic nutrition index (44.8 vs 48.6, p = 0.034), steroid use (51.9% vs 0%, p < 0.001), immunosuppressant use (48.1% vs 0%, p < 0.001), length of hospital stay (38 vs 27 days, p = 0.018), and discharge to care facility (29.6% vs 7.4%, p = 0.036) were higher in group A. Preoperative ODI (54.2 vs 43.2, p = 0.011) and 2-year follow-up SRS-22 scores (3.1 vs 3.6 p = 0.019) were worse in group A. No differences were observed in radiographic alignment.<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS<\/jats:title>\nPatients with autoimmune disease had higher complication rates and worse PROMs following ASD surgery in this study. There was no difference in spinal alignment compared with controls. Multidisciplinary planning and full disclosure of possible adverse effects should be completed prior to correction of ASD in patients with autoimmune disease.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.spine221392","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T13:52:16Z","timestamp":1680875536000},"page":"65-74","source":"Crossref","is-referenced-by-count":7,"title":["Medical complications following adult spinal deformity correction in patients with autoimmune disease"],"prefix":"10.3171","volume":"39","author":[{"given":"Rina Therese R.","family":"Madelar","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"},{"name":"Department of Orthopedics, The Medical City, Ortigas Avenue, Pasig City, Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Oe","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"},{"name":"Department of Orthopedic Surgery, Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Yamato","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"},{"name":"Department of Orthopedic Surgery, Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiko","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Banno","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Arima","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Ide","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohiro","family":"Yamada","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenta","family":"Kurosu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichi","family":"Nakai","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukihiro","family":"Matsuyama","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Autoimmun Rev","first-page":"119","article-title":"The epidemiology of autoimmune diseases","volume":"2","author":"Cooper GS","year":"2003","unstructured":"Cooper GS, Stroehla BC. The epidemiology of autoimmune diseases. Autoimmun Rev. 2003;2(3):119\u2013125.12848952"},{"issue":"4","key":"b2","series-title":"Int J Celiac Dis","first-page":"151","article-title":"The world incidence and prevalence of autoimmune diseases is increasing","volume":"3","author":"Lerner A","year":"2015","unstructured":"Lerner A, Jeremias P, Matthias T. The world incidence and prevalence of autoimmune diseases is increasing. Int J Celiac Dis. 2015;3(4):151\u2013155."},{"key":"b3","series-title":"J Immunol Res","first-page":"183591","article-title":"Systemic autoimmune diseases 2014","volume":"2015","author":"Shi G","year":"2015","unstructured":"Shi G, Zhang J, Zhang ZJ, Zhang X. Systemic autoimmune diseases 2014. J Immunol Res. 2015;2015:183591.26090482"},{"key":"b4","series-title":"World Neurosurg","first-page":"260","article-title":"Does rheumatoid arthritis affect the infection and complications rates of spinal surgery? A systematic review and meta-analysis","volume":"145","author":"Zhang S","year":"2021","unstructured":"Zhang S, Wang L, Bao L, Does rheumatoid arthritis affect the infection and complications rates of spinal surgery? A systematic review and meta-analysis. World Neurosurg. 2021;145:260\u2013266.32977033"},{"issue":"4","key":"b5","series-title":"J Neurosurg Spine","first-page":"367","article-title":"Surgical outcomes of long spinal fusions for scoliosis in adult patients with rheumatoid arthritis","volume":"22","author":"Mesfin A","year":"2015","unstructured":"Mesfin A, El Dafrawy MH, Jain A, Surgical outcomes of long spinal fusions for scoliosis in adult patients with rheumatoid arthritis. 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Perioperative outcomes associated with thoracolumbar 3-column osteotomies for adult spinal deformity patients with rheumatoid arthritis. J Neurosurg Spine. 2019;30(6):822\u2013832.30835702"},{"issue":"10","key":"b12","series-title":"Spine J","first-page":"1861","article-title":"Comparison of adult spinal deformity patients with and without rheumatoid arthritis undergoing primary non-cervical spinal fusion surgery: a nationwide analysis of 52,818 patients","volume":"18","author":"Bernstein DN","year":"2018","unstructured":"Bernstein DN, Kurucan E, Menga EN, Molinari RW, Rubery PT, Mesfin A. Comparison of adult spinal deformity patients with and without rheumatoid arthritis undergoing primary non-cervical spinal fusion surgery: a nationwide analysis of 52,818 patients. 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