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Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up.

Publication ,  Journal Article
Hamilton, DK; Kanter, AS; Bolinger, BD; Mundis, GM; Nguyen, S; Mummaneni, PV; Anand, N; Fessler, RG; Passias, PG; Park, P; La Marca, F ...
Published in: Eur Spine J
August 2016

INTRODUCTION: Minimally invasive surgical (MIS) techniques are gaining popularity in the treatment of adult spinal deformity (ASD). The premise is that MIS techniques will lead to equivalent outcomes and a reduction in perioperative complications when compared with open techniques. Potential issues with MIS techniques are a limited capacity to correct lumbar lordosis, unknown long-term efficacy, and the potential need for revision surgery. This study compares reoperation rates and reasons for reoperation following MIS, hybrid, and open surgery for ASD through multicenter database analysis. METHODS: We retrospectively analyzed a prospective multicenter ASD database comparing open and MIS correction techniques. Inclusion criteria were: age > 18 years with minimum 20° coronal lumbar Cobb angle, a minimum of three levels fused, and minimum 2-year follow-up. Patients were propensity matched for preoperative sagittal vertebral axis (SVA), pelvic incidence-lumbar lordosis (PI-LL), and number of levels fused. We included 189 patients from three propensity-matched subgroups of 63 patients each: (1) MIS: lateral or transforaminal lumbar interbody fusion (LIF) and percutaneous pedicle instrumentation, (2) Hybrid: MIS LIF with open posterior segmental fixation (PSF), and (3) OPEN: open posterior fixation ± osteotomies. RESULTS: With propensity matching, there were significant differences between groups in pre-op SVA or PI-LL (p > 0.05). The MIS group had significantly fewer levels fused (5.4) (0-14) than the OPEN group (7.4) (p = 0.002) (0-17). The rate of revision surgery was significantly different between the groups with a higher rate of revision (27 %) amongst the HYB group versus MIS = 11.1 %, and OPEN = 12.0 %. The most common reason for reoperation in the OPEN and HYB groups was a postoperative neurological deficit (7.9 and 11.1 %), respectively. The most common reason for reoperation in the MIS group was pseudoarthrosis (7.9 %). CONCLUSIONS: Reoperation rates were not statistically different among the MIS, and OPEN surgical groups, but differed significantly on multivariate analysis with HYB group. The incidence of reoperations was twice as high in the Hybrid group compared to OPEN and MIS.

Duke Scholars

Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

August 2016

Volume

25

Issue

8

Start / End Page

2605 / 2611

Location

Germany

Related Subject Headings

  • Young Adult
  • Spinal Fusion
  • Spinal Curvatures
  • Reoperation
  • Orthopedics
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies
 

Citation

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Hamilton, D. K., Kanter, A. S., Bolinger, B. D., Mundis, G. M., Nguyen, S., Mummaneni, P. V., … International Spine Study Group (ISSG), . (2016). Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up. Eur Spine J, 25(8), 2605–2611. https://doi.org/10.1007/s00586-016-4443-2
Hamilton, D Kojo, Adam S. Kanter, Bryan D. Bolinger, Gregory M. Mundis, Stacie Nguyen, Praveen V. Mummaneni, Neel Anand, et al. “Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up.Eur Spine J 25, no. 8 (August 2016): 2605–11. https://doi.org/10.1007/s00586-016-4443-2.
Hamilton DK, Kanter AS, Bolinger BD, Mundis GM, Nguyen S, Mummaneni PV, et al. Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up. Eur Spine J. 2016 Aug;25(8):2605–11.
Hamilton, D. Kojo, et al. “Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up.Eur Spine J, vol. 25, no. 8, Aug. 2016, pp. 2605–11. Pubmed, doi:10.1007/s00586-016-4443-2.
Hamilton DK, Kanter AS, Bolinger BD, Mundis GM, Nguyen S, Mummaneni PV, Anand N, Fessler RG, Passias PG, Park P, La Marca F, Uribe JS, Wang MY, Akbarnia BA, Shaffrey CI, Okonkwo DO, International Spine Study Group (ISSG). Reoperation rates in minimally invasive, hybrid and open surgical treatment for adult spinal deformity with minimum 2-year follow-up. Eur Spine J. 2016 Aug;25(8):2605–2611.
Journal cover image

Published In

Eur Spine J

DOI

EISSN

1432-0932

Publication Date

August 2016

Volume

25

Issue

8

Start / End Page

2605 / 2611

Location

Germany

Related Subject Headings

  • Young Adult
  • Spinal Fusion
  • Spinal Curvatures
  • Reoperation
  • Orthopedics
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Follow-Up Studies