Do Outcome Parameters Correlate with Surgical Complications Utilizing the SRS Questionnaire in the Treatment of AIS?

New York, NY, USA

INTRODUCTION: The SRS questionnaire was prospectively utilized to evaluate patient outcome measures in the surgical treatment of AIS with respect to surgical complications. The questionnaire consists of 24 questions divided into seven equally weighted domains as determined by factor analysis: pain, general self image, postoperative self image, general function, overall level of activity, postoperative function, and satisfaction. To our knowledge there is no study utilizing the SRS questionnaire comparing surgical complications to patient based outcome.

METHODS: The questionnaire was administered preoperatively and at two-year follow-up. The number of complete questionnaires administered at six centers with two year follow-up was n=242. The questionnaires were scored and comparisons were made between three general complication types; instrumentation related complications, loss of radiographically acceptable parameters, and major medical complications. Statistical significance was defined as P ‹ .05. Comparisons were then made between the group of patients with complications vs. the total cohort as well as the cohort without complications.

RESULTS: Thirty complications were reported in 242 patients (13%). 7 Instrumentation related complications, (3 Rod failure without loss of correction, 1 prominent instrumentation, 1 prominent instrumentation with re-operation, 1 breakage with loss of correction, 1 breakage with re-operation for pseudoarthrosis). 20 loss of radiographically acceptable parameters; 2 Loss of correction, 2 Loss of correction with proximal junctional kyphosis › 10 degrees, 5 kyphosis › 40 degrees, 1 T1 rib angles › 10 degrees, 1 Distal junctional kyphosis › 10 degrees, 7 proximal junctional kyphosis › 10 degrees, 1 kyphosis › 40 degrees with proximal junctional kyphosis 1 loss of correction with a medical complication, pneumothorax (PTX), 3 medical complications. (1 DVT, 2 PTX). No significant differences were seen in all preoperative and postoperative domains with respect to instrumentation-related complications, loss of radiographically acceptable parameters, or major medical complications, when the complications group was compared with the non-complication group.

CONCLUSIONS: A complication rate of 12% was seen in this study group population. However, no significant differences were seen with respect to instrumentation related complications, loss of radiographically acceptable parameters, or major medical complications, in patient-based outcomes reported via the SRS Questionnaire.