Durability of stand-alone anterolateral interbody fusion in staged minimally invasive circumferential scoliosis surgery with delayed posterior instrumentation due to medical necessity.
Adult spinal deformity
Anterior lumbar interbody fusion
Anterolateral approach
Circumferential minimally invasive surgery
Lateral lumbar interbody fusion
Stand-alone fusion
Journal
Spine deformity
ISSN: 2212-1358
Titre abrégé: Spine Deform
Pays: England
ID NLM: 101603979
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
20
09
2022
accepted:
17
06
2023
pubmed:
1
8
2023
medline:
1
8
2023
entrez:
31
7
2023
Statut:
ppublish
Résumé
Circumferential minimally invasive scoliosis surgeries are often staged, wherein anterior and/or lateral lumbar interbody fusion is followed by percutaneous posterior fixation days later. This study examines the impact on outcomes when posterior augmentation was delayed due to unexpected medical issues following the first stage, anterolateral procedure. A retrospective review was conducted of all patients undergoing minimally invasive circumferential deformity corrections from 2006 to 2019. Patients in whom planned posterior fixation was postponed due to medical necessity or safety concerns were identified. Perioperative surgical metrics and radiographic parameters were collected. Three of the six patients initially scheduled for circumferential fusion never underwent posterior augmentation due to symptomatic improvement (2.3, 5, and 10.7 years of follow-up). The other three underwent posterior fixation once medically optimized after an average interval of 4.7 months (range 3.2-7.8 months) due to persistent symptoms. It was also observed that the average coronal malalignment in the postoperative period was 5.1 cm in the group requiring further fixation and only 1.6 cm in the group which did not. In select cases, the indirect decompression and stability conferred by minimally invasive anterolateral arthrodesis alone may afford adequate pain relief to delay or even avoid posterior fixation in patients with adult spinal deformity.
Identifiants
pubmed: 37525061
doi: 10.1007/s43390-023-00725-7
pii: 10.1007/s43390-023-00725-7
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1495-1501Informations de copyright
© 2023. The Author(s), under exclusive licence to Scoliosis Research Society.
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