P125. Evaluating the impact of multiple sclerosis on 2-year postoperative outcomes following long fusion for adult spinal deformity: a propensity score matched analysis

Abstract

<h3>BACKGROUND CONTEXT</h3> The impact of neuromuscular disorders such as multiple sclerosis (MS) on outcomes following long segment (4+ level) fusion is underreported. <h3>PURPOSE</h3> To identify the impact of MS on two-year (2Y) postoperative complications and revisions following 4 level fusion for ASD. <h3>STUDY DESIGN/SETTING</h3> Retrospective cohort. <h3>PATIENT SAMPLE</h3> Patients undergoing 4+ level fusion for ASD were identified from the New York State Statewide Planning and Research Cooperative System. <h3>OUTCOME MEASURES</h3> Two-year postoperative complications and reoperations. <h3>METHODS</h3> Patients undergoing 4-level fusion for ASD were identified from the New York Statewide Planning and Research Cooperative System. Patients with a baseline diagnosis of MS were also identified. Patients with infectious/traumatic/neoplastic indications were excluded. Subjects were 1:1 propensity score-matched (MS to no-MS) by age, sex, and race and compared for rates of 2-year postoperative complications and reoperations. Logistic regression models were utilized to determine risk factors for adverse outcomes at 2 years. <h3>RESULTS</h3> A total of 86 patients were included (n=43 per group). Age (50.1 vs 50.1 years, p=0.225), sex and race were comparable between groups. MS pts incurred higher charges for their surgical visit ($125,906 vs $84,006, p=0.007) with similar LOS (8.1 vs 5.3 days, p>0.05). MS patients experienced comparable rates of overall medical complications (30.1% vs 25.6%) and surgical complications (34.9% vs 30.2%) all p>0.05. MS pts had similar rates of 2-year revisions (16.3% vs 9.3%, p=0.333). MS was not associated with medical, surgical or overall complications or revisions at minimum 2-year follow-up. <h3>CONCLUSIONS</h3> Patients with MS experienced similar postoperative course compared to those without MS following 4-level fusion for ASD. This data supports the findings of multiple previously published case series' that long segment fusions for ASD can be performed relatively safely in patients with MS. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.