Yu Yamato1,2, Tomohiko Hasegawa3, Go Yoshida3, Tatsuya Yasuda4, Tomohiro Banno3, Shin Oe3,5, Hideyuki Arima3, Yuki Mihara3, Hiroki Ushirozako3, Tomohiro Yamada3, Koichiro Ide3, Yuh Watanabe3, Yukihiro Matsuyama3. 1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan. yamato@hama-med.ac.jp. 2. Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan. yamato@hama-med.ac.jp. 3. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan. 4. Department of Orthopaedic Surgery, Iwata City Hospital, Iwata City, Shizuoka, Japan. 5. Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan.
Abstract
PURPOSE: To determine the effect of planned two-stage surgery using lateral lumbar interbody fusion (LLIF) on the perioperative complication rate following corrective fusion surgery in patients with kyphoscoliosis. METHODS: Consecutive patients with degenerative scoliosis who underwent corrective fusion were divided into a control group that underwent single-stage posterior-only surgery and a group that underwent planned two-staged surgery with LLIF and posterior corrective fusion. We collected the patient background and surgical data and assessed the perioperative complication rates. We also investigated spinopelvic parameters and patient-reported outcome measurements (PROMs). RESULTS: One hundred and thirty-eight patients of mean age 69.8 (range, 50-84) years who met the study inclusion criteria were included. The two-stage group (n = 75) underwent a staged anterior-posterior surgical procedure, and the control group (n = 63) underwent single-stage surgery. There was no significant between-group difference in the incidence of perioperative complications, except for deep wound infection (reoperation is necessary for surgical site infection). Revision surgery within 3 months of the initial surgery was more common in the control group (n = 8, 12.7%) than in the two-stage group (n = 3, 4.0%). Spinopelvic parameters and PROMs were significantly better in the two-stage group at 2 years postoperatively. CONCLUSION: The complication rate for planned two-stage surgery was similar to that of previous posterior-only single-stage surgery. However, early reoperation was less common, and the degree of spinal correction and clinical results were significantly better after two-stage surgery.
PURPOSE: To determine the effect of planned two-stage surgery using lateral lumbar interbody fusion (LLIF) on the perioperative complication rate following corrective fusion surgery in patients with kyphoscoliosis. METHODS: Consecutive patients with degenerative scoliosis who underwent corrective fusion were divided into a control group that underwent single-stage posterior-only surgery and a group that underwent planned two-staged surgery with LLIF and posterior corrective fusion. We collected the patient background and surgical data and assessed the perioperative complication rates. We also investigated spinopelvic parameters and patient-reported outcome measurements (PROMs). RESULTS: One hundred and thirty-eight patients of mean age 69.8 (range, 50-84) years who met the study inclusion criteria were included. The two-stage group (n = 75) underwent a staged anterior-posterior surgical procedure, and the control group (n = 63) underwent single-stage surgery. There was no significant between-group difference in the incidence of perioperative complications, except for deep wound infection (reoperation is necessary for surgical site infection). Revision surgery within 3 months of the initial surgery was more common in the control group (n = 8, 12.7%) than in the two-stage group (n = 3, 4.0%). Spinopelvic parameters and PROMs were significantly better in the two-stage group at 2 years postoperatively. CONCLUSION: The complication rate for planned two-stage surgery was similar to that of previous posterior-only single-stage surgery. However, early reoperation was less common, and the degree of spinal correction and clinical results were significantly better after two-stage surgery.
Authors: Frank J Schwab; Nicola Hawkinson; Virginie Lafage; Justin S Smith; Robert Hart; Gregory Mundis; Douglas C Burton; Breton Line; Behrooz Akbarnia; Oheneba Boachie-Adjei; Richard Hostin; Christopher I Shaffrey; Vincent Arlet; Kirkham Wood; Munish Gupta; Shay Bess; Praveen V Mummaneni Journal: Eur Spine J Date: 2012-05-17 Impact factor: 3.134
Authors: Pankaj Kandwal; Ankur Goswami; G Vijayaraghavan; K R Subhash; Ashok Jaryal; B N Upendra; Arvind Jayaswal Journal: Spine Deform Date: 2016-06-16
Authors: Peter G Passias; Gregory W Poorman; Cyrus M Jalai; Breton Line; Bassel Diebo; Paul Park; Robert Hart; Douglas Burton; Frank Schwab; Virginie Lafage; Shay Bess; Thomas Errico Journal: Spine J Date: 2017-03-21 Impact factor: 4.166
Authors: William C Horton; Courtney W Brown; Keith H Bridwell; Steven D Glassman; Se-Il Suk; Charles W Cha Journal: Spine (Phila Pa 1976) Date: 2005-02-15 Impact factor: 3.468
Authors: Giovanni Andrea La Maida; Francesco Luceri; Francesco Gallozzi; Marcello Ferraro; Misaggi Bernardo Journal: Eur Spine J Date: 2015-10-06 Impact factor: 3.134