Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study

Masuda, Soichiro; Fujibayashi, Shunsuke; Takemoto, Mitsuru; Ota, Masahiro; Onishi, Eijiro; Odate, Seiichi; Tsutumi, Ryosuke; Izeki, Masanori; Kimura, Hiroaki; Tanida, Seiichi; Otsuki, Bungo; Murata, Koichi; Shimizu, Takayoshi; Matsuda, Shinji

doi:10.1007/s00586-023-07539-1

Eur Spine J

2023

DOI: 10.1007/s00586-023-07539-1

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Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study

Soichiro Masuda

Shunsuke Fujibayashi

Mitsuru Takemoto

et al.

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Cited by 1 publication

(2 citation statements)

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“…15 In addition, lateral lumbar interbody fusion (LLIF) has been introduced in ASD surgery in recent years. [16][17][18] Large footprint interbody cages with an anteroposterior wedge lordotic angle of up to 30 degrees can be implanted, allowing for a significant restoration of lumbar lordosis. 12 Furthermore, the large cage axial surface reduces the risk of endplate fracture and cage subsidence.…”

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“…A recent study found a 168.5% increase in the use of the ALIF procedure in the United States between 2007 and 2014, with nearly 50,000 surgeries performed during that period 15 . In addition, lateral lumbar interbody fusion (LLIF) has been introduced in ASD surgery in recent years 16–18 . Large footprint interbody cages with an anteroposterior wedge lordotic angle of up to 30 degrees can be implanted, allowing for a significant restoration of lumbar lordosis 12 .…”

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Pedicle Subtraction Osteotomy Versus Multilevel Anterior Lumbar Interbody Fusion and Lateral Lumbar Interbody Fusion in the Treatment of Adult Spinal Deformity

Chi,

Zhang,

Fontaine

et al. 2023

Clinical Spine Surgery

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Study Design: Retrospective cohort study. Objective: The aim of this study was to compare the outcomes of pedicle subtraction osteotomy (PSO) with multilevel anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) in posterior long-segment fusion. Background: PSO and ALIF/LLIF are 2 techniques used to restore lumbar lordosis and correct sagittal alignment, with each holding its unique advantages and disadvantages. As there are situations where both techniques can be employed, it is important to compare the risks and benefits of both. Patients and Methods: Patients aged 18 years or older who underwent PSO or multilevel ALIF/LLIF with posterior fusion of 7–12 levels and pelvic fixation were identified. 1:1 propensity score was used to match PSO and ALIF/LLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Logistic regression was used to compare medical and surgical outcomes. Trends and costs were generated for both groups as well. Results: ALIF/LLIF utilization in posterior long fusion has been steadily increasing since 2010, whereas PSO utilization has significantly dropped since 2017. PSO was associated with an increased risk of durotomy (P < 0.001) and neurological injury (P = 0.018). ALIF/LLIF was associated with increased rates of postoperative radiculopathy (P = 0.005). Patients who underwent PSO had higher rates of pseudarthrosis within 1 and 2 years (P = 0.015; P = 0.010), 1-year hardware failure (P = 0.028), and 2-year reinsertion of instrumentation (P = 0.009). Reoperation rates for both approaches were not statistically different at any time point throughout the 5-year period. In addition, there were no significant differences in both procedural and 90-day postoperative costs. Conclusions: PSO was associated with higher rates of surgical complications compared with anterior approaches. However, there was no significant difference in overall reoperation rates. Spine surgeons should select the optimal technique for a given patient and the type of lordotic correction required.

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confidence: 99%

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confidence: 99%

Pedicle Subtraction Osteotomy Versus Multilevel Anterior Lumbar Interbody Fusion and Lateral Lumbar Interbody Fusion in the Treatment of Adult Spinal Deformity

Chi,

Zhang,

Fontaine

et al. 2023

Clinical Spine Surgery

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Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study

Cited by 1 publication

References 26 publications

Pedicle Subtraction Osteotomy Versus Multilevel Anterior Lumbar Interbody Fusion and Lateral Lumbar Interbody Fusion in the Treatment of Adult Spinal Deformity

Pedicle Subtraction Osteotomy Versus Multilevel Anterior Lumbar Interbody Fusion and Lateral Lumbar Interbody Fusion in the Treatment of Adult Spinal Deformity

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