Age at Initial Surgery and Surgical Burden in Congenital Spinal Deformity

Seidali S. Abdaliyev, Daniyar Zh. Yestay, Olzhas Bekarissov, Sergei Valentinovich Vissarionov, Dina Saginova, Murat Baidarbekov, Serik Zh. Serikov

Medicina, 2026

Полный текст Открытый доступ: Gold Метаданные (CSL-JSON)
DOI 10.3390/medicina62061053
Достоверность данных 70 средняя
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Аннотация

Background: Congenital spinal deformities associated with multiple vertebral anomalies often require surgical correction during growth; however, the relationship between age at initial surgery and cumulative treatment burden remains insufficiently characterized. Objective: To evaluate whether age at first surgery is associated with surgical burden and radiographic outcomes in children with congenital spinal deformity treated with conventional posterior instrumented fusion. Methods: In this retrospective single-center cohort study, 32 children treated between 2019 and 2024 were stratified by age at initial surgery into two groups: ≤6 years (n = 13) and 7–12 years (n = 19). Planned staged procedures and growth-friendly techniques were excluded. Surgical burden was assessed as the total number of procedures, procedures per patient-year, and high surgical burden, defined as ≥3 procedures. Radiographic outcomes included postoperative Cobb angle and correction percentage. Adjusted analyses were performed using Poisson regression with log follow-up as an offset term, logistic regression, and linear regression. Results: Baseline deformity severity was similar between groups (mean preoperative Cobb angle, 45.2 ± 19.0° vs. 43.1 ± 21.6°; p = 0.61). Both groups showed significant within-group improvement after surgery (p < 0.001), with no significant between-group difference in correction percentage (61.5 ± 35.2% vs. 64.8 ± 30.6%; p = 0.78). The total number of procedures and procedures per patient-year were also comparable between groups (p = 0.21 and p = 0.58, respectively). However, high surgical burden was more frequent in the younger group (38.5% vs. 10.5%; p = 0.048). In adjusted analysis, older age at first surgery was associated with lower odds of high surgical burden (OR = 0.78; 95% CI: 0.61–0.99; p = 0.042), whereas no variable independently predicted correction percentage. Conclusions: Younger age at initial surgery was associated with a greater likelihood of high surgical burden, whereas the time-adjusted operation rate and early coronal correction were similar between groups.