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Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients.

Publication ,  Journal Article
Haque, RM; Mundis, GM; Ahmed, Y; El Ahmadieh, TY; Wang, MY; Mummaneni, PV; Uribe, JS; Okonkwo, DO; Eastlack, RK; Anand, N; Kanter, AS; Park, P ...
Published in: Neurosurg Focus
May 2014

OBJECT: Various surgical approaches, including open, minimally invasive, and hybrid techniques, have gained momentum in the management of adult spinal deformity. However, few data exist on the radiographic outcomes of different surgical techniques. The objective of this study was to compare the radiographic and clinical outcomes of the surgical techniques used in the treatment of adult spinal deformity. METHODS: The authors conducted a retrospective review of two adult spinal deformity patient databases, a prospective open surgery database and a retrospective minimally invasive surgery (MIS) and hybrid surgery database. The time frame of enrollment in this study was from 2007 to 2012. Spinal deformity patients were stratified into 3 surgery groups: MIS, hybrid surgery, and open surgery. The following pre- and postoperative radiographic parameters were assessed: lumbar major Cobb angle, lumbar lordosis, pelvic incidence minus lumbar lordosis (PI-LL), sagittal vertical axis, and pelvic tilt. Scores on the Oswestry Disability Index (ODI) and a visual analog scale (VAS) for both back and leg pain were also obtained from each patient. RESULTS: Of the 234 patients with adult spinal deformity, 184 patients had pre- and postoperative radiographs and were thus included in the study (MIS, n = 42; hybrid, n = 33; open, n = 109). Patients were a mean of 61.7 years old and had a mean body mass index of 26.9 kg/m(2). Regarding radiographic outcomes, the MIS group maintained a significantly smaller mean lumbar Cobb angle (13.1°) after surgery compared with the open group (20.4°, p = 0.002), while the hybrid group had a significantly larger lumbar curve correction (26.6°) compared with the MIS group (18.8°, p = 0.045). The mean change in the PI-LL was larger for the hybrid group (20.6°) compared with the open (10.2°, p = 0.023) and MIS groups (5.5°, p = 0.003). The mean sagittal vertical axis correction was greater for the open group (25 mm) compared with the MIS group (≤ 1 mm, p = 0.008). Patients in the open group had a significantly larger postoperative thoracic kyphosis (41.45°) compared with the MIS patients (33.5°, p = 0.005). There were no significant differences between groups in terms of pre- and postoperative mean ODI and VAS scores at the 1-year follow-up. However, patients in the MIS group had much lower estimated blood loss and transfusion rates compared with patients in the hybrid or open groups (p < 0.001). Operating room time was significantly longer with the hybrid group compared with the MIS and open groups (p < 0.001). Major complications occurred in 14% of patients in the MIS group, 14% in the hybrid group, and 45% in the open group (p = 0.032). CONCLUSIONS: This study provides valuable baseline characteristics of radiographic parameters among 3 different surgical techniques used in the treatment of adult spinal deformity. Each technique has advantages, but much like any surgical technique, the positive and negative elements must be considered when tailoring a treatment to a patient. Minimally invasive surgical techniques can result in clinical outcomes at 1 year comparable to those obtained from hybrid and open surgical techniques.

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Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

May 2014

Volume

36

Issue

5

Start / End Page

E13

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Haque, R. M., Mundis, G. M., Ahmed, Y., El Ahmadieh, T. Y., Wang, M. Y., Mummaneni, P. V., … International Spine Study Group, . (2014). Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients. Neurosurg Focus, 36(5), E13. https://doi.org/10.3171/2014.3.FOCUS1424
Haque, Raqeeb M., Gregory M. Mundis, Yousef Ahmed, Tarek Y. El Ahmadieh, Michael Y. Wang, Praveen V. Mummaneni, Juan S. Uribe, et al. “Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients.Neurosurg Focus 36, no. 5 (May 2014): E13. https://doi.org/10.3171/2014.3.FOCUS1424.
Haque RM, Mundis GM, Ahmed Y, El Ahmadieh TY, Wang MY, Mummaneni PV, et al. Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients. Neurosurg Focus. 2014 May;36(5):E13.
Haque, Raqeeb M., et al. “Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients.Neurosurg Focus, vol. 36, no. 5, May 2014, p. E13. Pubmed, doi:10.3171/2014.3.FOCUS1424.
Haque RM, Mundis GM, Ahmed Y, El Ahmadieh TY, Wang MY, Mummaneni PV, Uribe JS, Okonkwo DO, Eastlack RK, Anand N, Kanter AS, La Marca F, Akbarnia BA, Park P, Lafage V, Terran JS, Shaffrey CI, Klineberg E, Deviren V, Fessler RG, International Spine Study Group. Comparison of radiographic results after minimally invasive, hybrid, and open surgery for adult spinal deformity: a multicenter study of 184 patients. Neurosurg Focus. 2014 May;36(5):E13.

Published In

Neurosurg Focus

DOI

EISSN

1092-0684

Publication Date

May 2014

Volume

36

Issue

5

Start / End Page

E13

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Scoliosis
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female