Assessing 10-Year Risk of Revision Surgery and Postoperative Complications Following Thoracic or Lumbar Fusion Surgery in HIV-Positive Patients

作者：Arman Kishan, Harmon Khela, Jeffrey Wang, Thomas P. Cancian, Philip M. Parel, Ethan Cottrill, William C. Eward, Christopher I. Shaffrey, Paritash Tahmasebpour, Andrew J. Schoenfeld, Christopher J. Kleck, Raffi S. Avedian, Peter G. Passias, Paweł Jankowski · 发表于：Spine · 年份：2025 · DOI：10.1097/brs.0000000000005524 · 被引用次数：1 · 研究领域：HIV-related health complications and treatments、Bone and Joint Diseases、HIV Research and Treatment

STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate the 10-year risk of revision surgery and postoperative complications in HIV-positive patients undergoing thoracic or lumbar fusion, compared with matched HIV-negative controls. SUMMARY OF BACKGROUND DATA: As HIV-positive patients live longer due to advancements in antiretroviral therapy, the prevalence of spinal degenerative and deformity-related conditions has risen. While prior studies suggest higher complication rates in HIV-positive individuals undergoing spine surgery, long-term outcomes following thoracic or lumbar fusion remain poorly characterized. MATERIALS AND METHODS: A retrospective cohort analysis was performed using a national claims database of over 170 million patients (2010-2023). Patients who underwent thoracic or lumbar fusion were categorized into deformity fusion (≥4 levels) or degenerative fusion (<4 levels). HIV-positive patients were matched 2:1 with HIV-negative controls by age, gender, and Charlson comorbidity index. Complications were assessed at 30 and 90 days postoperatively. Long-term outcomes, including revision surgery and complication-related procedures, were evaluated over 10 years using Cox proportional hazards models. RESULTS: A total of 3538 HIV-positive patients and 903,713 controls were identified, with 3534 HIV-positive patients matched to 7064 controls. HIV-positive patients had lower rates of acute kidney injury, urinary tract infections, myocardial infarction, and infec...