4.5 Article

Combined anterior-posterior versus all-posterior approaches for adult spinal deformity correction: a matched control study

期刊

EUROPEAN SPINE JOURNAL
卷 31, 期 7, 页码 1754-1764

出版社

SPRINGER
DOI: 10.1007/s00586-022-07249-0

关键词

Anterior; Spine; Deformity; Surgery; Scoliosis; Results

资金

  1. DePuy Synthes
  2. Medtronic

向作者/读者索取更多资源

This study compared the surgical outcomes between combined anterior-posterior approaches and all-posterior approach in adult spinal deformity (ASD) patients. The results showed that combined approaches had longer surgeries, more blood loss, and longer ICU stays, but comparable complication rates. However, they had significantly less readmissions and reoperations at 2 years. Combined approaches achieved more individualized and harmonious deformity correction and improved long-term functional outcomes.
Purpose Anterior approaches are gaining popularity for adult spinal deformity (ASD) surgeries especially with the introduction of hyperlordotic cages and improvement in MIS techniques. Combined Approaches provide powerful segmental sagittal correction potential and increase the surface area available for fusion in ASD surgery, both of which would improve overall. This is the first study directly comparing surgical outcomes between combined anterior-posterior approaches and all-posterior approach in a matched ASD population. Methods This is a retrospective matched control cohort analysis with substitution using a multicenter prospectively collected ASD data of patients with > 2 year FU. Matching criteria include: age, American Society of Anesthesiologists Score, Lumbar Cobb angle, sagittal deformity (Global tilt) and ODI. Results In total, 1024 ASD patients were available for analysis. 29 Combined Approaches patients met inclusion criteria, and only 22 could be matched (1:2 ratio). Preoperative non-matched demographical, clinical, surgical and radiological parameters were comparable between both groups. Combined approaches had longer surgeries (548 mns vs 283) with more blood loss (2850 ml vs 1471) and needed longer ICU stays (74 h vs 27). Despite added morbidity, they had comparable complication rates but with significantly less readmissions (9.1% vs 38.1%) and reoperations (18.2% vs 43.2%) at 2 years. Combined Approaches achieved more individualised and harmonious deformity correction initially. At the 2 years control, Combined Approaches patients reported better outcomes as measured by COMI and SRS scores. This trend was maintained at 3 years. Conclusion Despite an increased initial surgical invasiveness, combined approaches seem to achieve more harmonious correction with superior sagittal deformity control; they need fewer revisions and have improved long-term functional outcomes when compared to all-posterior approaches for ASD deformity correction.

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.5
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据