Is There a Patient Profile That Characterizes a Patient With Adult Spinal Deformity as a Candidate for Minimally Invasive Surgery?


Journal Article

STUDY DESIGN: Retrospective review. OBJECTIVES: The goal of this study was to evaluate the baseline characteristics of patients chosen to undergo traditional open versus minimally invasive surgery (MIS) for adult spinal deformity (ASD). METHODS: A multicenter review of 2 databases including ASD patients treated with surgery. Inclusion criteria were age >45 years, Cobb angle minimum of 20°, and minimum 2-year follow-up. Preoperative radiographic parameters and disability outcome measures were reviewed. RESULTS: A total of 350 patients were identified: 173 OPEN patients and 177 MIS. OPEN patients were significantly younger than MIS patients (61.5 years vs 63.74 years, P = .013). The OPEN group had significantly more females (87% vs 76%, P = .006), but both groups had similar body mass index. Preoperative lumbar Cobb was significantly higher for the OPEN group (34.2°) than for the MIS group (26.0°, P < .001). The mean preoperative Oswestry Disability Index was significantly higher in the MIS group (44.8 in OPEN patients and 49.8 in MIS patients, P < .011). The preoperative Numerical Rating Scale value for back pain was 7.2 in the OPEN group and 6.8 in the MIS group preoperatively, P = .100. CONCLUSIONS: Patients chosen for MIS for ASD are slightly older and have smaller coronal deformities than those chosen for open techniques, but they did not have a substantially lesser degree of sagittal malalignment. MIS surgery was most frequently utilized for patients with an sagittal vertical axis under 6 cm and a baseline pelvic incidence and lumbar lordosis mismatch under 30°.

Full Text

Duke Authors

Cited Authors

  • Eastlack, RK; Mundis, GM; Wang, M; Mummaneni, PV; Uribe, J; Okonkwo, D; Akbarnia, BA; Anand, N; Kanter, A; Park, P; Lafage, V; Shaffrey, C; Fessler, R; Deviren, V; International Spine Study Group,

Published Date

  • October 2017

Published In

Volume / Issue

  • 7 / 7

Start / End Page

  • 703 - 708

PubMed ID

  • 28989851

Pubmed Central ID

  • 28989851

International Standard Serial Number (ISSN)

  • 2192-5682

Digital Object Identifier (DOI)

  • 10.1177/2192568217716151


  • eng

Conference Location

  • England