Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Tian, Chen; Gerdhem, Paul

doi:10.1007/s00586-017-5248-7

Cited by 17 publications

(11 citation statements)

References 26 publications

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“…Degenerative lumbar scoliosis is a progressive coronal deformity, including sagittal malalignment, that usually occurs in patients over 40 years of age. As we know, DLS is a spinal deformity defined as a lumbar Cobb angle greater than 10° without previous history of scoliosis [1,24], and the Cobb angle is generally below 40° [12]. Curve prevalence in adult degenerative scoliosis(ADS) is inversely proportional to curve magnitude.…”

Section: Discussionmentioning

confidence: 99%

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Degenerative lumbar scoliosis patients with proximal junctional kyphosis have lower muscularity, fatty degeneration at the lumbar area

Zeng

Chen

et al. 2020

Eur Spine J

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Purpose To assess the lumbar muscle conditions on the incidence of proximal junctional kyphosis (PJK) after long-level correction and instrumentation surgery for degenerative lumbar scoliosis (DLS) patients with a minimum 2-year follow-up. Methods Eighty-four DLS patients undergoing long instrumented fusion surgery (≥ 5 vertebrae) were retrospectively studied. According to the occurrence of PJK at the final follow-up, patients were divided into the PJK group and the Non-PJK group. Patient characteristics, surgical variables and radiographic parameters were analyzed statistically. The lumbar muscularity (cross-sectional area of muscle-disc ratio × 100) and fatty degeneration (signal intensity of muscle-subcutaneous fat ratio × 100) were evaluated on magnetic resonance imaging . Results The prevalence of PJK was 20.24%. Gender, age at surgery, body mass index, uppermost instrumented vertebrae level, fusions extending to the sacrum, and levels fused were not significantly different between the groups. Lower bone mineral density, smaller functional cross-sectional area (FCSA) of paraspinal extensor muscles (PSE), higher lean muscle-fat index and total muscle-fat index of PSE, greater preoperative thoracolumbar kyphosis (TLK), smaller preoperative sacral slope (SS), larger preoperative sagittal vertical axis were identified in PJK group. Logistic regression analysis showed that osteoporosis, preoperative TLK > 15°, SS > 24°, FCSA of PSE > 138.75, and total muscle-fat index of PSE > 4.08 were independently associated with PJK. The final follow-up VAS score for back pain was higher, and SRS-22 subcategories of pain, function, self-image, and total score were significantly lower in the PJK group. Conclusion Osteoporosis, lower lumbar muscularity and higher fatty degeneration, preoperative greater TLK and smaller SS were found to be strongly associated with the presence of PJK in DLS.

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Section: Discussionmentioning

confidence: 99%

“…Degenerative lumbar scoliosis (DLS) is a spinal deformity defined as a lumbar Cobb angle greater than 10° without previous history of scoliosis [1]. DLS is common with prevalence ranging from 7.5 to 68% [2][3][4][5][6][7], which was about 13.3% in the Chinese Han population aged more than 40 years old [8].…”

Section: Introductionmentioning

confidence: 99%

Degenerative lumbar scoliosis patients with proximal junctional kyphosis have lower muscularity, fatty degeneration at the lumbar area

Zeng

Chen

et al. 2020

Eur Spine J

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“…Several Swedish studies of spinal surgery have reported a reoperation rate ranging from 5.4% to 27%, depending on the type of operation and the length of follow-up. [3][4][5][6] However, the majority of these studies [4][5][6] are based on data from the Swedish National Spine Register (Swespine) and might underestimate the number of reoperations. A study comparing Swespine with insurance claims found that only 65% of complications were registered in Swespine.…”

Section: Introductionmentioning

confidence: 99%

Revision Spinal Surgery at a University Hospital: Incidence, Causes, and Microbiological Agents in Infected Patients

Dymén

Westin²,

Baranto³

et al. 2022

Int J Spine Surg

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Background: The number of spinal surgeries performed worldwide have significantly increased over the past decade. However, to the best of our knowledge, there are no national or international studies that report the overall picture of complications following spinal surgery. This article sought to identify the incidence and causes of reoperations in patients undergoing spinal surgery, as well as the average time from index surgery to reoperation. Furthermore, the purpose was to identify the microbiological agents present in cultures from infected patients.Methods: This was a retrospective cohort study that used a university hospital's medical records as the data source. The study population comprised 2110 patients who underwent spinal surgery during a 40-month period between 2015 and 2018. All suspected reoperations were verified manually. Additional data collected for reoperations included cause, time from index surgery, and laboratory results from cultures. Descriptive analysis was used.Results: The incidence of reoperations during the study period was 11% (n = 232). The most common cause of reoperation was infection (28%, n = 65), followed by implant-related causes (19%, n = 44) and hemorrhage/hematoma (15%, n = 34). The time between index surgery and reoperation varied, but half of all reoperations occurred within 30 days. Coagulase-negative staphylococci were the most common type of bacteria (positive cultures in 39% of infected patients). Conclusion:The number of reoperations in the studied hospital were high during the study period. Infections accounted for a large percentage of reoperations, suggesting that effective preventive measures might significantly reduce the total number of reoperations.Clinical Relevance: Postoperative infection causing reoperations after spinal surgeries is a large problem, and finding effective preventive measures should be a priority for caregivers.Level of Evidence: 3.

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“…Being able to quantify the invasiveness of an operation and its possible risks in terms of complications is important in the decision-making process for patients and surgeons. Having a valid and applicable index is also valuable for comparing outcomes and complication rates across studies and in benchmarking activities, such as those typically carried out in registries [10,11,12].…”

Section: Introductionmentioning

confidence: 99%

Validation of a surgical invasiveness index in patients with lumbar spinal disorders registered in the Spine Tango registry

et al. 2020

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Introduction Being able to quantify the invasiveness of a surgical procedure is important to weigh up its associated risks, since invasiveness governs the blood loss, operative time and likelihood of complications. Mirza et al. (Spine (Phila Pa 1976) 33:2651–2661, 2008) published an invasiveness index for spinal surgery. We evaluated the validity of a modified version of the Mirza invasiveness index (mMII), adapted for use with registry data. Methods A cross-sectional analysis was performed with data acquired from the Spine Tango registry including 21,634 patients. The mMII was calculated as the sum of six possible interventions on each vertebral level: decompression, fusion and stabilization either on anterior or posterior structures. The association between the mMII and blood loss, operative time and complications was evaluated using multiple regression, adjusting for possible confounders. Results The mean (± SD) mMII was 3.9 ± 5.0 (range 0–40). A 1-point increase in the mMII was associated with an additional blood loss of 12.8% (95% CI 12.6–13.0; p < 0.001) and an increase of operative time of 10.4 min (95% CI 10.20–10.53; p < 0.001). The R2 for the blood loss model was of 43% and for operative time, 47%. The mean mMII was significantly (p < 0.001) higher in patients with surgical complications (4.5 ± 5.6) and general medical complications (6.5 ± 7.0) compared to those without (3.8 ± 4.9). Our results were comparable to those reported in the original publication of Mirza et al. Conclusion The mMII appeared to be a valid measure of surgical invasiveness in our study population. It can be used in predictor models and to adjust for surgical case-mix when comparing outcomes in different studies or different hospitals/surgeons in a registry.

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Outcome of surgery for degenerative lumbar scoliosis: an observational study using the Swedish Spine register

Cited by 17 publications

References 26 publications

Degenerative lumbar scoliosis patients with proximal junctional kyphosis have lower muscularity, fatty degeneration at the lumbar area

Degenerative lumbar scoliosis patients with proximal junctional kyphosis have lower muscularity, fatty degeneration at the lumbar area

Revision Spinal Surgery at a University Hospital: Incidence, Causes, and Microbiological Agents in Infected Patients

Validation of a surgical invasiveness index in patients with lumbar spinal disorders registered in the Spine Tango registry

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