Objective: To evaluate patient-reported outcome measures and reoperation rates after primary fusion surgery from the thoracolumbar spine to the sacrum for adult spinal deformity (ASD). Materials and Methods: In this study, 63 patients with ASD who underwent primary fusion surgery from the sacrum to thoracolumbar area at a single specialty spine centre were reviewed. All patients were followed-up for a minimum of 2 years with a mean follow-up period of 44 months. The preoperative and final follow-up Oswestry disability index (ODI) scores and radiographs were reviewed. Patients who reached a minimal clinically important difference (MCID) were determined. Moreover, reoperations for any reason during follow-up were noted. Results: The median ODI scores improved significantly from 40 preoperatively to 28 at the final follow-up (p≤0.01). A majority of patients achieved MCID (52%), and reoperation was performed in 33% of the patients. The reasons for reoperation were proximal junctional failure (n=7), implant irritation (n=5), pseudarthrosis repair (n=4), infection (n=4) and recurrent stenosis (n=1). Conclusion: Primary instrumented fusion from the thoracolumbar spine to the sacrum for ASD is associated with high re-operation rates. A significant improvement in ODI was seen at the final follow-up in patients who did not receive a re-operation. Whereas, among the re-operated patients, only 19% achieved a MCID in ODI score.
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