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Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications

CONTEXT: Literature on treating pediatric spinal deformity with navigation is limited, particularly using large nationally represented cohorts. Further, the comparison of single-institution data to national-level database outcomes is also lacking. AIM: (1) To compare navigated versus conventional po...

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Autores principales: Katz, Austen D., Song, Junho, Hasan, Sayyida, Galina, Jesse M., Virk, Sohrab, Silber, Jeff Scott, Essig, David, Sarwahi, Vishal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336894/
https://www.ncbi.nlm.nih.gov/pubmed/37448507
http://dx.doi.org/10.4103/jcvjs.jcvjs_28_23
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author Katz, Austen D.
Song, Junho
Hasan, Sayyida
Galina, Jesse M.
Virk, Sohrab
Silber, Jeff Scott
Essig, David
Sarwahi, Vishal
author_facet Katz, Austen D.
Song, Junho
Hasan, Sayyida
Galina, Jesse M.
Virk, Sohrab
Silber, Jeff Scott
Essig, David
Sarwahi, Vishal
author_sort Katz, Austen D.
collection PubMed
description CONTEXT: Literature on treating pediatric spinal deformity with navigation is limited, particularly using large nationally represented cohorts. Further, the comparison of single-institution data to national-level database outcomes is also lacking. AIM: (1) To compare navigated versus conventional posterior pediatric deformity surgery based on 30-day outcomes and perioperative factors using the National Surgical Quality Improvement Program (NSQIP) database and (2) to compare the outcomes of the NSQIP navigated group to those of fluoroscopy-only and navigated cases from a single-institution. SETTINGS AND DESIGN: Retrospective cohort study. SUBJECTS AND METHODS: Pediatric patients who underwent posterior deformity surgery with and without navigation were included. Primary outcomes were 30-day readmission, reoperation, morbidity, and complications. The second part of this study included AIS patients < 18 years old at a single institution between 2015 and 2019. Operative time, length of stay, transfusion rate, and complication rate were compared between single-institution and NSQIP groups. STATISTICAL ANALYSIS USED: Univariate analyses with independent t-test and Chi-square or Fisher's exact test was used. Multivariate analyses through the application of binary logistic regression models. RESULTS: Part I of the study included 16,950 patients, with navigation utilized in 356 patients (2.1%). In multivariate analysis, navigation predicted reoperation, deep wound infection, and sepsis. After controlling for operative year, navigation no longer predicted reoperation. In Part II of the study, 288 single institution AIS patients were matched to 326 navigation patients from the NSQIP database. Operative time and transfusion rate were significantly higher for the NSQIP group. CONCLUSIONS: On a national scale, navigation predicted increased odds of reoperation and infectious-related events and yielded greater median relative value units (RVUs) per case but had longer operating room (OR) time and fewer RVUs-per-minute. After controlling for operative year, RVUs-per-minute and reoperation rates were similar between groups. The NSQIP navigated surgery group was associated with significantly higher operative time and transfusion rates compared to the single-institution groups.
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spelling pubmed-103368942023-07-13 Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications Katz, Austen D. Song, Junho Hasan, Sayyida Galina, Jesse M. Virk, Sohrab Silber, Jeff Scott Essig, David Sarwahi, Vishal J Craniovertebr Junction Spine Original Article CONTEXT: Literature on treating pediatric spinal deformity with navigation is limited, particularly using large nationally represented cohorts. Further, the comparison of single-institution data to national-level database outcomes is also lacking. AIM: (1) To compare navigated versus conventional posterior pediatric deformity surgery based on 30-day outcomes and perioperative factors using the National Surgical Quality Improvement Program (NSQIP) database and (2) to compare the outcomes of the NSQIP navigated group to those of fluoroscopy-only and navigated cases from a single-institution. SETTINGS AND DESIGN: Retrospective cohort study. SUBJECTS AND METHODS: Pediatric patients who underwent posterior deformity surgery with and without navigation were included. Primary outcomes were 30-day readmission, reoperation, morbidity, and complications. The second part of this study included AIS patients < 18 years old at a single institution between 2015 and 2019. Operative time, length of stay, transfusion rate, and complication rate were compared between single-institution and NSQIP groups. STATISTICAL ANALYSIS USED: Univariate analyses with independent t-test and Chi-square or Fisher's exact test was used. Multivariate analyses through the application of binary logistic regression models. RESULTS: Part I of the study included 16,950 patients, with navigation utilized in 356 patients (2.1%). In multivariate analysis, navigation predicted reoperation, deep wound infection, and sepsis. After controlling for operative year, navigation no longer predicted reoperation. In Part II of the study, 288 single institution AIS patients were matched to 326 navigation patients from the NSQIP database. Operative time and transfusion rate were significantly higher for the NSQIP group. CONCLUSIONS: On a national scale, navigation predicted increased odds of reoperation and infectious-related events and yielded greater median relative value units (RVUs) per case but had longer operating room (OR) time and fewer RVUs-per-minute. After controlling for operative year, RVUs-per-minute and reoperation rates were similar between groups. The NSQIP navigated surgery group was associated with significantly higher operative time and transfusion rates compared to the single-institution groups. Wolters Kluwer - Medknow 2023 2023-06-13 /pmc/articles/PMC10336894/ /pubmed/37448507 http://dx.doi.org/10.4103/jcvjs.jcvjs_28_23 Text en Copyright: © 2023 Journal of Craniovertebral Junction and Spine https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Katz, Austen D.
Song, Junho
Hasan, Sayyida
Galina, Jesse M.
Virk, Sohrab
Silber, Jeff Scott
Essig, David
Sarwahi, Vishal
Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title_full Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title_fullStr Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title_full_unstemmed Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title_short Navigated versus conventional pediatric spinal deformity surgery: Navigation independently predicts reoperation and infectious complications
title_sort navigated versus conventional pediatric spinal deformity surgery: navigation independently predicts reoperation and infectious complications
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10336894/
https://www.ncbi.nlm.nih.gov/pubmed/37448507
http://dx.doi.org/10.4103/jcvjs.jcvjs_28_23
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