SLIM: Single Long-Incision Minimally Invasive Surgery.


Journal

Spine
ISSN: 1528-1159
Titre abrégé: Spine (Phila Pa 1976)
Pays: United States
ID NLM: 7610646

Informations de publication

Date de publication:
20 Jun 2023
Historique:
received: 09 02 2023
accepted: 03 06 2023
medline: 20 6 2023
pubmed: 20 6 2023
entrez: 20 6 2023
Statut: aheadofprint

Résumé

Retrospective cohort studys. The objective of this study is to determine differences in outcomes in AIS patients undergoing spinal deformity correction surgery using a posterior spinal fusion approach versus single- and triple-incision minimally invasive surgery (MIS). MIS increased in popularity as surgeons focus moved towards soft tissue preservation, but carries technical demands and increased surgical time compared to PSF. Surgeries performed over 2016-2020 were included. Cohorts were formed based upon surgical approach: PSF versus single incision MIS (SLIM) versus traditional MIS (3MIS). There were a total of seven sub-analyses. Demographic, radiographic, and perioperative data were collected for the 3 groups. Kruskal-Wallis and chi-square tests were used for continuous and categorical variables respectively. 532 patients met our inclusion criteria, 296 PSF, 179 3MIS, and 59 SLIM.EBL (mL) (P<0.00001) and LOS (P<0.00001) was significantly higher in PSF than in SLIM and 3MIS. Surgical time was significantly higher in 3MIS than PSF and SLIM (P=0.0012).PSF patients had significantly lower postop T5-T12 kyphosis (P<0.00001) and percent kyphosis change (P<0.00001). Morphine equivalence was significantly higher in the PSF group during total hospital stay (P=0.0042).SLIM and 3MIS patients were more likely to return to non-contact (P=0.0096) and contact sports (P=0.0095) within six months and reported lower pain scores (P<0.001) at six months post operation. SLIM has similar operative time to PSF and is technically similar to PSF, while maintaining the surgical and post-operative outcome advantages of 3MIS.

Sections du résumé

STUDY DESIGN METHODS
Retrospective cohort studys.
OBJECTIVE OBJECTIVE
The objective of this study is to determine differences in outcomes in AIS patients undergoing spinal deformity correction surgery using a posterior spinal fusion approach versus single- and triple-incision minimally invasive surgery (MIS).
SUMMARY OF BACKGROUND DATA BACKGROUND
MIS increased in popularity as surgeons focus moved towards soft tissue preservation, but carries technical demands and increased surgical time compared to PSF.
METHODS METHODS
Surgeries performed over 2016-2020 were included. Cohorts were formed based upon surgical approach: PSF versus single incision MIS (SLIM) versus traditional MIS (3MIS). There were a total of seven sub-analyses. Demographic, radiographic, and perioperative data were collected for the 3 groups. Kruskal-Wallis and chi-square tests were used for continuous and categorical variables respectively.
RESULTS RESULTS
532 patients met our inclusion criteria, 296 PSF, 179 3MIS, and 59 SLIM.EBL (mL) (P<0.00001) and LOS (P<0.00001) was significantly higher in PSF than in SLIM and 3MIS. Surgical time was significantly higher in 3MIS than PSF and SLIM (P=0.0012).PSF patients had significantly lower postop T5-T12 kyphosis (P<0.00001) and percent kyphosis change (P<0.00001). Morphine equivalence was significantly higher in the PSF group during total hospital stay (P=0.0042).SLIM and 3MIS patients were more likely to return to non-contact (P=0.0096) and contact sports (P=0.0095) within six months and reported lower pain scores (P<0.001) at six months post operation.
CONCLUSION CONCLUSIONS
SLIM has similar operative time to PSF and is technically similar to PSF, while maintaining the surgical and post-operative outcome advantages of 3MIS.

Identifiants

pubmed: 37339279
doi: 10.1097/BRS.0000000000004752
pii: 00007632-990000000-00392
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.

Auteurs

Vishal Sarwahi (V)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Keshin Visahan (K)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Sayyida Hasan (S)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Aravind Patil (A)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Matan Grunfeld (M)

New York Medical College, Valhalla, NY.

Aaron Atlas (A)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Jesse Galina (J)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Alexandre Ansorge (A)

Division of Pediatric Orthopaedics, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland.

Yungtai Lo (Y)

Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY.

Terry D Amaral (TD)

Department of Pediatric Orthopaedics, Cohen Children's Medical Center, New Hyde Park, NY.

Romain Dayer (R)

Division of Pediatric Orthopaedics, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland.
Pediatric Orthopedics and Traumatology Unit, Lausanne University Hospital, Laussanne, Switzerland.

Classifications MeSH