Patient-Centered Outcomes Following Prone Lateral Single-Position Approach to Same-Day Circumferential Spine Surgery.
Journal
Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646
Informations de publication
Date de publication:
24 Mar 2023
24 Mar 2023
Historique:
entrez:
27
3
2023
pubmed:
28
3
2023
medline:
28
3
2023
Statut:
aheadofprint
Résumé
Retrospective study. Evaluate surgical characteristics and postoperative 2-year results of the PL approach to spinal fusion. Prone-lateral(PL) single positioning has recently gained popularity in spine surgery due to lower blood loss and operative time, but has yet to be examined for other notable outcomes, including realignment and patient-reported measures. We included circumferential spine fusion patients with minimum one-year follow-up. Patients stratified into groups based on undergoing PL approach versus same-day staged(Staged). Means comparison tests identified differences in baseline parameters. Multivariable logistic regression, controlling for age, levels fused, and Charlson Comorbidity Index(CCI) was used to determine the influence of approach on complication rates, radiographic and patient-reported outcomes up to two years. 122 patients were included. 72(59%) same-day staged and 50(41%) PL. PL patients were older with lower BMI(both P<0.05). Patients undergoing PL procedures had lower EBL and operative time(both P<0.001), along with fewer osteotomies(63% vs. 91%,P<0.001). This translated to shorter length of stay(3.8 d vs. 4.9,P=0.041). PL procedures demonstrated better correction in both PT(4.0 vs. -0.2,P=0.033 and PI-LL(-3.7 vs. 3.1,P=0.012). PL procedures were more likely to improve in GAP relative pelvic version(OR: 2.3,[1.5-8.8];P=0.003]. PL patients suffered less complications during the perioperative period and greater improvement in NRS-Back(-6.0 vs. -3.3,P=0.031), with less reoperations(0.0% vs. 4.8%,P=0.040) by two years. Patients undergoing prone lateral single position procedures received less invasive procedures with better correction of pelvic compensation, as well as earlier discharge. The prone lateral cohort also demonstrated greater clinical improvement and lower rate of reoperations by two years following spinal corrective surgery. III.
Sections du résumé
STUDY DESIGN
METHODS
Retrospective study.
OBJECTIVE
OBJECTIVE
Evaluate surgical characteristics and postoperative 2-year results of the PL approach to spinal fusion.
SUMMARY OF BACKGROUND DATA
BACKGROUND
Prone-lateral(PL) single positioning has recently gained popularity in spine surgery due to lower blood loss and operative time, but has yet to be examined for other notable outcomes, including realignment and patient-reported measures.
METHODS
METHODS
We included circumferential spine fusion patients with minimum one-year follow-up. Patients stratified into groups based on undergoing PL approach versus same-day staged(Staged). Means comparison tests identified differences in baseline parameters. Multivariable logistic regression, controlling for age, levels fused, and Charlson Comorbidity Index(CCI) was used to determine the influence of approach on complication rates, radiographic and patient-reported outcomes up to two years.
RESULTS
RESULTS
122 patients were included. 72(59%) same-day staged and 50(41%) PL. PL patients were older with lower BMI(both P<0.05). Patients undergoing PL procedures had lower EBL and operative time(both P<0.001), along with fewer osteotomies(63% vs. 91%,P<0.001). This translated to shorter length of stay(3.8 d vs. 4.9,P=0.041). PL procedures demonstrated better correction in both PT(4.0 vs. -0.2,P=0.033 and PI-LL(-3.7 vs. 3.1,P=0.012). PL procedures were more likely to improve in GAP relative pelvic version(OR: 2.3,[1.5-8.8];P=0.003]. PL patients suffered less complications during the perioperative period and greater improvement in NRS-Back(-6.0 vs. -3.3,P=0.031), with less reoperations(0.0% vs. 4.8%,P=0.040) by two years.
CONCLUSIONS
CONCLUSIONS
Patients undergoing prone lateral single position procedures received less invasive procedures with better correction of pelvic compensation, as well as earlier discharge. The prone lateral cohort also demonstrated greater clinical improvement and lower rate of reoperations by two years following spinal corrective surgery.
LEVEL OF EVIDENCE
METHODS
III.
Identifiants
pubmed: 36972128
doi: 10.1097/BRS.0000000000004648
pii: 00007632-990000000-00280
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.