Risk factors for unplanned reoperation after the treatment of early-onset scoliosis with traditional dual growing rods combined with apical control techniques.

Abstract

This study aimed to identify the incidence of and potential risk factors for unplanned reoperations following traditional dual growing rods (TDGRs) combined with apical control techniques (ACTs; TDGRs+ACTs). A retrospective study of patients with early-onset scoliosis treated with TDGRs+ACTs from June 2006 to November 2022 was conducted. The patients were grouped based on the occurrence of unplanned reoperations. Demographic characteristics, surgery-related data, radiographic parameters, complications, unplanned reoperations, and clinical outcomes were collected. Univariate and multivariate analyses were conducted to identify potential risk factors for unplanned reoperation following TDGR+ACT treatment. Receiver operating characteristic (ROC) curve analysis was used to identify the cutoff values. A total of 60 patients were enrolled. The mean age at initial surgery was 7.2 years, with a mean follow-up duration of 6.5 years. Eleven patients (18.3%) underwent 14 unplanned reoperations by the final follow-up. Logistic regression analysis revealed that the 1-year progression rate of global kyphosis (GK; OR 1.211, p = 0.018) was a significant independent risk factor for unplanned reoperation. ROC analysis revealed that the 1-year progression rate of GK had good discriminatory ability (area under the curve 0.855, 95% CI 0.743-0.966), and the cutoff value was 12.5°/year. At the last follow-up, the mean emotion score in the reoperation group was significantly lower than that in the nonreoperation group (63.18 ± 20.16 vs 76.54 ± 18.90, p = 0.042). The unplanned reoperation rate of TDGR+ACT treatment was 18.3%. The 1-year progression rate of GK was an independent risk factor for unplanned reoperation after TDGR+ACT, with the incidence of unplanned reoperation significantly increasing when the 1-year progression rate exceeded 12.5°/year. Unplanned reoperations not only affect the physical health of patients but also impose a heavy burden on their mental health.