Thirty-Day Reoperation and Readmission Rates After Correction of Adult Spinal Deformity via Circumferential Minimally Invasive Surgery-Analysis of a 7-Year Experience.

STUDY DESIGN: Single-center retrospective analysis of consecutive patients who have undergone circumferential minimally invasive surgery (cMIS) for correction of adult spinal deformity (ASD).

OBJECTIVES: To study the rates of reoperations and readmissions within the first 30 days following cMIS for correction of ASD.

BACKGROUND: Hospital readmission and reoperation rates have been emphasized as an important measure of quality and cost-effectiveness of care. However, there is little information about the readmission rates following cMIS correction of ASD.

METHODS: This is a retrospective cohort study of 214 consecutive patients with ASD who underwent correction using cMIS involving at least 2 levels. Major complications encountered during surgery or within 30 days following the index procedure that needed reoperation or readmission were recorded. The primary outcomes measured were early readmission, and early reoperation.

RESULTS: An average of 4 levels were fused. Nineteen complications were noted in the 30-day period following the index surgery, giving an early complication rate of 8.9%. Twelve of those complications occurred during the initial hospitalization and 7 complications occurred after the patient had been discharged home. Forty-seven percent of the complications occurred within the first 3 years of our experience, 37% in the next 2 years, and only 16% in the following 3 years. The 30-day readmission rate was 3.3%, which showed no statistically significant difference based on the number of levels fused.

CONCLUSIONS: Our study delivers significant evidence that efforts to reduce hospital readmissions for ASD patients should begin by concentrating on the postoperative complications. Although minimally invasive approaches will not eliminate all complications, they may have an effect on reducing the rate of major complications, most notably the rate of postoperative infection. This in turn can lead to a substantially lower readmission and reoperation rate as is reported in our study.

LEVEL OF EVIDENCE: Level IV, case series.