Osteoarthritis is not a peri-operative risk factor or indicator of poor clinical outcomes with surgical correction for thoracolumbar scoliosis

Background: Understanding peri-operative influences of patients’ past medical history during spinal surgery is essential for promoting good clinical outcomes. A paucity of literature exists regarding the effect of common degenerative disorders like arthritis on spinal fusion outcomes. Methods: A retrospective review of a prospectively maintained database was utilized to examine patients undergoing spine fusion surgery at any spinal segment. Patients with a past medical history of arthritis were identified and analyzed for the following peri-operative events. Results: 532 patients met inclusion criteria, of which 192 suffered from comorbid osteoarthritis. Patients with arthritis were significantly older ( P <00.1), had a higher BMI ( P =0.0193), and were more likely to be former smokers ( P <0.001). When examining intra-operative features, the arthritic cohort construct length was significantly longer (5.79 vs. 6.55, P =0.0112). There were no significant differences in rates of intra-operative complication. Post-operatively, there were no differences in complications, either in surgical site infection ( P =0.89) or in the rate of venous thrombotic events ( P =1). On follow-up, there were no significant differences in rate of instrumentation failure ( P =0.11) or need for revision surgery ( P =0.32). Multivariable analysis demonstrated the same trend for all intra-operative findings and all post-operative observations. Conclusion: Arthritis was not associated with increased incidence of intra-operative complications or increased need for fusion revision for our cohort. The presence of arthritis did yield an increased intra-operative blood loss without clear clinical significance. These results suggest that the presence of additional degenerative inflammatory disease does not intrinsically yield a greater incidence of peri-operative complications or failure rates.