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Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity.

Publication ,  Journal Article
Than, KD; Park, P; Tran, S; Mundis, GM; Fu, K-M; Uribe, JS; Okonkwo, DO; Nunley, PD; Fessler, RG; Eastlack, RK; Kanter, A; Anand, N ...
Published in: World Neurosurg
June 2019

BACKGROUND: Spinal deformity surgery is often invasive and lengthy. Staging surgery over separate operative days may reduce complications. Staging is often used in minimally invasive treatment of adult spinal deformity (ASD). OBJECTIVE: To investigate the impact of staging on complication rates between hybrid (HYB; minimally invasive interbody with open posterior screw and rod fixation) and circumferential minimally invasive surgery (cMIS; minimally invasive interbody and screw/rod placement) procedures in patients with ASD. METHODS: A multicenter database of patients with ASD was reviewed. Patients who underwent staging (at least 3 levels) and 2 years of follow-up were analyzed. A total of 99 patients underwent staging: 53 cMIS and 46 HYB surgeries. Propensity matching for levels fused resulted in 19 patients in each group. Intra- and perioperative complications were assessed. RESULTS: Three HYB but no cMIS intraoperative complications occurred. More HYB patients had perioperative complications than cMIS patients. Neurologic complications were more frequent in HYB versus cMIS. Other complications did not differ significantly. Thirty-day reoperations were higher with cMIS than HYB, but there was no difference in reoperation rate at long-term follow-up. cMIS patients had greater improvement in the Oswestry Disability Index. There was no difference in complications between staged versus unstaged cMIS surgeries. CONCLUSIONS: cMIS staged surgeries appear safer than HYB staged surgeries, and equally safe to cMIS unstaged surgeries. Perioperative complications were significantly higher for HYB staged surgeries. HYB surgeries may have better results when performed in a single setting, whereas cMIS surgeries can be performed in 1 or 2 stages depending on surgeon preference.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2019

Volume

126

Start / End Page

e1337 / e1342

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Curvatures
  • Retrospective Studies
  • Postoperative Complications
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Than, K. D., Park, P., Tran, S., Mundis, G. M., Fu, K.-M., Uribe, J. S., … International Spine Study Group, . (2019). Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity. World Neurosurg, 126, e1337–e1342. https://doi.org/10.1016/j.wneu.2019.03.090
Than, Khoi D., Paul Park, Stacie Tran, Gregory M. Mundis, Kai-Ming Fu, Juan S. Uribe, David O. Okonkwo, et al. “Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity.World Neurosurg 126 (June 2019): e1337–42. https://doi.org/10.1016/j.wneu.2019.03.090.
Than KD, Park P, Tran S, Mundis GM, Fu K-M, Uribe JS, et al. Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity. World Neurosurg. 2019 Jun;126:e1337–42.
Than, Khoi D., et al. “Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity.World Neurosurg, vol. 126, June 2019, pp. e1337–42. Pubmed, doi:10.1016/j.wneu.2019.03.090.
Than KD, Park P, Tran S, Mundis GM, Fu K-M, Uribe JS, Okonkwo DO, Nunley PD, Fessler RG, Eastlack RK, Kanter A, Anand N, LaMarca F, Passias PG, Mummaneni PV, International Spine Study Group. Analysis of Complications with Staged Surgery for Less Invasive Treatment of Adult Spinal Deformity. World Neurosurg. 2019 Jun;126:e1337–e1342.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

June 2019

Volume

126

Start / End Page

e1337 / e1342

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spinal Fusion
  • Spinal Curvatures
  • Retrospective Studies
  • Postoperative Complications
  • Minimally Invasive Surgical Procedures
  • Middle Aged
  • Male
  • Humans
  • Female