The Comparison of Spinopelvic Parameters, Complications, and Clinical Outcomes After Spinal Fusion to S1 with or without Additional Sacropelvic Fixation for Adult Spinal Deformity

Spine ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bo Han ◽  
Peng Yin ◽  
Yong Hai ◽  
Yunzhong Cheng ◽  
Li Guan ◽  
...  
2002 ◽  
Vol 2 (5) ◽  
pp. 55-56 ◽  
Author(s):  
Jen-Yi Chang ◽  
John Kostuik ◽  
Ann Sieber

2021 ◽  
Author(s):  
Qiang Luo ◽  
Yong-Chan Kim ◽  
Ki-Tack Kim ◽  
Kee-Yong Ha ◽  
Joonghyun Ahn ◽  
...  

Abstract Background: To date, there is a paucity of reports clarifying the change of spinopelvic parameters in patients with adult spinal deformity (ASD) who underwent long segment spinal fusion using iliac screw (IS) and S2-alar-iliac screw (S2AI) fixation.Methods: A retrospective review of consecutive patients underwent deformity correction surgery for ASD between 2013 and 2017 was performed. Patients were divided into two groups based on whether IS or S2AI fixation was performed. All radiographic parameters were measured preoperatively, immediately postoperatively, and the last follow-up. Demographics, intraoperative and clinical data were analyzed between the two groups. Additionally, the cohort was subdivided according to the postoperative change in pelvic incidence (PI): subgroup (C) was defined as change in PI ≥5° and subgroup (NC) with change <5°. In subgroup analyses, the 2 different types of postoperative change of PI were directly compared.Results: A total of 142 patients met inclusion criteria: 111 who received IS and 31 received S2AI fixation. The IS group (65.6 ± 26, 39.8 ± 13.8) showed a significantly higher change in lumbar lordosis (LL) and upper lumbar lordosis (ULL) than the S2AI group (54.4 ± 17.9, 30.3 ± 9.9) (p<0.05). In subgroup (C), PI significantly increased from 53° preoperatively to 59° postoperatively at least 50% of IS cohort, with a mean change of 5.8° (p<0.05). The clinical outcomes at the last follow-up were significantly better in IS group than in S2AI group in terms of VAS scores for back and leg. The occurrence of sacroiliac joint pain and pelvic screw fracture were significantly greater in S2AI group than in IS group (25.8% vs 9%, p<0.05) and (16.1% vs 3.6%, p<0.05).Conclusions: IS fixation showed a greater change in LL and ULL than S2AI fixation in ASD surgery. PI may be changed under certain circumstances.


Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Khoi D Than ◽  
Stacie Tran ◽  
Dean Chou ◽  
Kai-Ming G Fu ◽  
Paul Park ◽  
...  

Abstract INTRODUCTION As the obesity epidemic continues and the recognition of adult spinal deformity (ASD) increases, a growing number of obese patients are undergoing surgery to correct ASD. Minimally invasive techniques may be advantageous for obese patients to minimize blood loss. To date, the literature examining the impact of obesity on complications after minimally invasive ASD surgery has been scarce. METHODS A multicenter database of ASD patients was reviewed. Patients who had at least 2 yr of follow-up were analyzed. Demographic, radiographic, clinical outcomes, and postoperative complications were assessed. A body mass index (BMI) threshold of 35 was selected to more accurately reflect real-world practices. RESULTS A total of 220 patients were included: 196 had a BMI <35 and 24 had a BMI >35 (26.3 vs 38.4, P < .001). When comparing patients with a BMI threshold of 35, there was no difference in baseline age, levels instrumented, and most pre- and postoperative radiographic parameters and clinical outcomes. Patients with BMI >35 did have higher preopearative back pain than BMI <35 (visual analog scale 7.9 vs 6.8, P = .013) and postoperative Cobb angle (17.8 vs 12.6, P = .031). There was no difference between groups in overall complications, reoperations, infections, implant failures, surgical site infections, or minor, cardiopulmonary, gastrointestinal, and operative complications. Patients with BMI >35 had more major (45.8% vs 23.0%, P = .015) and radiographic (37.5% vs 19.9%, P = .049) complications than patients with BMI <35. Patients with BMI <35 had more neurological complications (17.3% vs 0%, P = .026). CONCLUSION In this retrospective review of a large database of patients undergoing minimally invasive surgery for ASD, patients with BMI > 35 suffered from more major and radiographic complications but fewer neurological complications than patients with BMI <35.


2015 ◽  
Vol 20 (4) ◽  
pp. 609-616 ◽  
Author(s):  
Shinichi Inoue ◽  
Morsi Khashan ◽  
Takahito Fujimori ◽  
Sigurd H. Berven

Neurosurgery ◽  
2017 ◽  
Vol 80 (3) ◽  
pp. 489-497 ◽  
Author(s):  
Juan S. Uribe ◽  
Joshua Beckman ◽  
Praveen V. Mummaneni ◽  
David Okonkwo ◽  
Pierce Nunley ◽  
...  

Abstract BACKGROUND: The length of construct can potentially influence perioperative risks in adult spinal deformity (ASD) surgery. A head-to-head comparison between open and minimally invasive surgery (MIS) techniques for treatment of ASD has yet to be performed. OBJECTIVE: To examine the impact of MIS approaches on construct length and clinical outcomes in comparison to traditional open approaches when treating similar ASD profiles. METHODS: Two multicenter databases for ASD, 1 involving MIS procedures and the other open procedures, were propensity matched for clinical and radiographic parameters in this observational study. Inclusion criteria were ASD and minimum 2-year follow-up. Independent t-test and chi-square test were used to evaluate and compare outcomes. RESULTS: A total of 1215 patients were identified, with 84 patients matched in each group. Statistical significance was found for mean levels fused (4.8 for circumferential MIS [cMIS] and 10.1 for open), mean interbody fusion levels (3.6 cMIS and 2.4 open), blood loss (estimated blood loss 488 mL cMIS and 1762 mL open), and hospital length of stay (6.7 days cMIS and 9.7 days open). There was no significant difference in preoperative radiographic parameters or postoperative clinical outcomes (Owestry Disability Index and visual analog scale) between groups. There was a significant difference in postoperative lumbar lordosis (43.3° cMIS and 49.8° open) and pelvic incidence-lumbar lordosis correction (10.6° cMIS and 5.2° open) in the open group. There was no significant difference in reoperation rate between the 2 groups. CONCLUSION: MIS techniques for ASD may reduce construct length, reoperation rates, blood loss, and length of stay without affecting clinical and radiographic outcomes when compared to a similar group of patients treated with open techniques.


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