Incidence and risk factors of reoperation in patients with adjacent segment disease: A meta-analysis.
Adjacent segment disease
deformity
fusion
lumbar
spine
thoracic
Journal
Journal of craniovertebral junction & spine
ISSN: 0974-8237
Titre abrégé: J Craniovertebr Junction Spine
Pays: India
ID NLM: 101536746
Informations de publication
Date de publication:
Historique:
received:
24
01
2020
accepted:
25
02
2020
entrez:
19
6
2020
pubmed:
19
6
2020
medline:
19
6
2020
Statut:
ppublish
Résumé
This was a systematic review of the literature and meta-analysis. The objective of this study was to evaluate the current literature regarding the risk factors contributing to reoperation due to adjacent segment disease (ASD). ASD is a broad term referring to a variety of complications which might require reoperation. Revision spine surgery is known to be associated with poor clinical outcomes and high rate of complications. Unplanned reoperation has been suggested as a quality marker for the hospitals. An electronic search was conducted using PubMed. A total of 2467 articles were reviewed. Of these, 55 studies met our inclusion criteria and included an aggregate of 1940 patients. Data were collected pertaining to risk factors including age, sex, fusion length, lumbar lordosis, body mass index, pelvic incidence, sacral slope, pelvis tilt, initial pathology, type of fusion procedure, floating versus sacral or pelvic fusion, presence of preoperative facet or disc degeneration at the junctional segment, and sagittal orientation of the facets at the junctional segment. Analysis of the data was performed using Comprehensive Meta-Analysis software (Biostat, Inc.). The overall pooled incidence rate of reoperation due to ASD from all included studies was 0.08 (confidence interval: 0.065-0.098). Meta-regression analysis demonstrated no significant interaction between age and reoperation rate ( We found that 8% of patients in our included studies required reoperation due to ASD. Our analysis also revealed that longer fusion constructs correlated with a higher rate of subsequent revision surgery. Therefore, the surgeon should limit the number of fusion levels if possible to reduce the risk of future reoperation due to ASD. IV.
Sections du résumé
STUDY DESIGN
METHODS
This was a systematic review of the literature and meta-analysis.
OBJECTIVE
OBJECTIVE
The objective of this study was to evaluate the current literature regarding the risk factors contributing to reoperation due to adjacent segment disease (ASD).
SUMMARY OF BACKGROUND DATA
BACKGROUND
ASD is a broad term referring to a variety of complications which might require reoperation. Revision spine surgery is known to be associated with poor clinical outcomes and high rate of complications. Unplanned reoperation has been suggested as a quality marker for the hospitals.
MATERIALS AND METHODS
METHODS
An electronic search was conducted using PubMed. A total of 2467 articles were reviewed. Of these, 55 studies met our inclusion criteria and included an aggregate of 1940 patients. Data were collected pertaining to risk factors including age, sex, fusion length, lumbar lordosis, body mass index, pelvic incidence, sacral slope, pelvis tilt, initial pathology, type of fusion procedure, floating versus sacral or pelvic fusion, presence of preoperative facet or disc degeneration at the junctional segment, and sagittal orientation of the facets at the junctional segment. Analysis of the data was performed using Comprehensive Meta-Analysis software (Biostat, Inc.).
RESULTS
RESULTS
The overall pooled incidence rate of reoperation due to ASD from all included studies was 0.08 (confidence interval: 0.065-0.098). Meta-regression analysis demonstrated no significant interaction between age and reoperation rate (
CONCLUSIONS
CONCLUSIONS
We found that 8% of patients in our included studies required reoperation due to ASD. Our analysis also revealed that longer fusion constructs correlated with a higher rate of subsequent revision surgery. Therefore, the surgeon should limit the number of fusion levels if possible to reduce the risk of future reoperation due to ASD.
LEVEL OF EVIDENCE
METHODS
IV.
Identifiants
pubmed: 32549706
doi: 10.4103/jcvjs.JCVJS_10_20
pii: JCVJS-11-9
pmc: PMC7274364
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
9-16Informations de copyright
Copyright: © 2020 Journal of Craniovertebral Junction and Spine.
Déclaration de conflit d'intérêts
There are no conflicts of interest.
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