Evidence map›Paper›PMID 40679702›Full record

ArticleSpine deformity2025

Utility of routine postoperative imaging following posterior spinal fusion for AIS.

Soham Ghoshal, Shanika D Silva, David S Liu, K Mikayla Flowers, Margaret L Sullivan, Craig M Birch, Daniel J Hedequist, M Timothy Hresko, Grant D Hogue

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Article in Spine deformity, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Soham GhoshalHarvard Medical School, Boston, MA, USA.ORCID http://orcid.org/0000-0001-9078-8978
Shanika D SilvaDepartment of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
David S LiuHarvard Medical School, Boston, MA, USA.
K Mikayla FlowersDepartment of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Margaret L SullivanDepartment of Orthopaedic Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA.
Craig M BirchHarvard Medical School, Boston, MA, USA.
Daniel J HedequistHarvard Medical School, Boston, MA, USA.
M Timothy HreskoHarvard Medical School, Boston, MA, USA.
Grant D HogueHarvard Medical School, Boston, MA, USA. grant.hogue@childrens.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe necessity of routine radiographic imaging after spinal fusion surgery is debated due to variations in surgeons' practices. The aim of this study is to determine the role of immediate postoperative radiographic imaging following posterior spinal fusion for AIS. Our hypothesis is that routine immediate postoperative radiographic imaging in patients with AIS undergoing posterior spinal fusion does not impact the decision to return to the operating room.

methodsWe conducted a retrospective cohort study of AIS patients (ages 11-19) who underwent PSF at a single institution. The proportion of unplanned returns to the operating room (UPROR) cases was estimated with a Clopper-Pearson 95% confidence interval. Risk factors for UPROR were compared using Wilcoxon rank-sum and Fisher's exact tests.

resultsAmong 527 patients, only 3 (0.5%) had UPROR, and just 1 (0.2%) returned due to routine postoperative imaging findings. Patients with and without UPROR had similar surgical times (321 vs. 277 min, p = 0.24), blood loss (18% of EBV vs. 14% of EBV, p = 0.29), and intraoperative tranexamic acid use (p = 0.52). No demographic or surgical factors differed between the groups. The estimated excess radiation burden was 36.36 mSv.

conclusionThe decision to undergo reoperation based on routine immediate postoperative imaging findings is exceedingly rare. In addition, blood loss, surgical time, and use of TXA did not differ between those who did return to the operating room and those who did not. These findings demonstrate that most patients do not benefit from routine immediate postoperative imaging.

Indexed as

Postoperative CareScoliosisSpinal FusionAdolescentChildFemaleHumansMalePostoperative ComplicationsPostoperative PeriodRadiographyReoperationRetrospective StudiesRisk FactorsYoung AdultAdolescent idiopathic scoliosisAISPosterior spinal fusionPostoperative imagingReturn to OR

Identifiers

PMID40679702

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.