Abstract
Background context: Combined anteroposterior spinal fusion with instrumentation has been used for many years to treat adult thoracolumbar/lumbar scoliosis. This surgery remains a technical challenge to spine surgeons, and current literature reports high complication rates. Purpose: The purpose of this study is to validate a new hybrid technique (a combination of single-rod anterior instrumentation and a shorter posterior instrumentation to the sacrum) to treat adult thoracolumbar/lumbar scoliosis. Study design: This study is a retrospective consecutive case series of surgically treated patients with adult lumbar or thoracolumbar scoliosis. Patient sample :This is a retrospective study of 33 matched pairs of patients with adult scoliosis who underwent two different surgical procedures: a new hybrid technique versus a third-generation anteroposterior spinal fusion. Outcome measures: Preoperative and postoperative outcome measures include self-report measures, physiological measures, and functional measures. Methods: In a retrospective case-control study, 33 patients treated with the hybrid technique were matched with 33 patients treated with traditional anteroposterior fusion based on preoperative radiographic parameters. Mean follow-up in the hybrid group was 5.3 years (range, 2-11 years), compared with 4.6 years (range, 2-10 years) in the control group. Operating room (OR) time, estimated blood loss, and levels fused were collected as surrogates for surgical morbidity. Radiographic parameters were collected preoperatively, postoperatively, and at final follow-up. The Scoliosis Research Society Patient Questionnaire (SRS-22r) and Oswestry Disability Index (ODI) scores were collected for clinical outcomes. Results: Operating room time, EBL, and levels fused were significantly less in the hybrid group compared with the control group (p<.0001). The postoperative thoracic Cobb angle was similar between the hybrid and control techniques (p=.24); however, the hybrid technique showed significant improvement in the thoracolumbar/lumbar curves (p=.004) and the lumbosacral fractional curve (p<.0001). The major complication rate was less in the hybrid group compared with the control group (18% vs. 39%, p=.01). Clinical outcomes at final follow-up were not significantly different based on overall SRS-22r scores and ODI scores. Conclusion: The new hybrid technique demonstrates good long-term results, with less morbidity and fewer complications than traditional anteroposterior surgery select patients with thoracolumbar/lumbar scoliosis. This study received no funding. No potential conflict of interest-associated bias existed.
| Original language | English |
|---|---|
| Pages (from-to) | 637-645 |
| Number of pages | 9 |
| Journal | Spine Journal |
| Volume | 14 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 2014 Apr 1 |
| Externally published | Yes |
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Keywords
- Adult idiopathic degenerative scoliosis
- Anterior instrumentation
- Anteroposterior spinal fusion
- Long posterior spinal instrumentation
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
- Medicine(all)
Cite this
Adult thoracolumbar and lumbar scoliosis treated with long vertebral fusion to the sacropelvis : A comparison between new hybrid selective spinal fusion versus anterior-posterior spinal instrumentation. / Yagi, Mitsuru; Patel, Ravi; Lawhorne, Thomas W.; Cunningham, Matthew E.; Boachie-Adjei, Oheneba.
In: Spine Journal, Vol. 14, No. 4, 01.04.2014, p. 637-645.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adult thoracolumbar and lumbar scoliosis treated with long vertebral fusion to the sacropelvis
T2 - A comparison between new hybrid selective spinal fusion versus anterior-posterior spinal instrumentation
AU - Yagi, Mitsuru
AU - Patel, Ravi
AU - Lawhorne, Thomas W.
AU - Cunningham, Matthew E.
AU - Boachie-Adjei, Oheneba
PY - 2014/4/1
Y1 - 2014/4/1
N2 - Background context: Combined anteroposterior spinal fusion with instrumentation has been used for many years to treat adult thoracolumbar/lumbar scoliosis. This surgery remains a technical challenge to spine surgeons, and current literature reports high complication rates. Purpose: The purpose of this study is to validate a new hybrid technique (a combination of single-rod anterior instrumentation and a shorter posterior instrumentation to the sacrum) to treat adult thoracolumbar/lumbar scoliosis. Study design: This study is a retrospective consecutive case series of surgically treated patients with adult lumbar or thoracolumbar scoliosis. Patient sample :This is a retrospective study of 33 matched pairs of patients with adult scoliosis who underwent two different surgical procedures: a new hybrid technique versus a third-generation anteroposterior spinal fusion. Outcome measures: Preoperative and postoperative outcome measures include self-report measures, physiological measures, and functional measures. Methods: In a retrospective case-control study, 33 patients treated with the hybrid technique were matched with 33 patients treated with traditional anteroposterior fusion based on preoperative radiographic parameters. Mean follow-up in the hybrid group was 5.3 years (range, 2-11 years), compared with 4.6 years (range, 2-10 years) in the control group. Operating room (OR) time, estimated blood loss, and levels fused were collected as surrogates for surgical morbidity. Radiographic parameters were collected preoperatively, postoperatively, and at final follow-up. The Scoliosis Research Society Patient Questionnaire (SRS-22r) and Oswestry Disability Index (ODI) scores were collected for clinical outcomes. Results: Operating room time, EBL, and levels fused were significantly less in the hybrid group compared with the control group (p<.0001). The postoperative thoracic Cobb angle was similar between the hybrid and control techniques (p=.24); however, the hybrid technique showed significant improvement in the thoracolumbar/lumbar curves (p=.004) and the lumbosacral fractional curve (p<.0001). The major complication rate was less in the hybrid group compared with the control group (18% vs. 39%, p=.01). Clinical outcomes at final follow-up were not significantly different based on overall SRS-22r scores and ODI scores. Conclusion: The new hybrid technique demonstrates good long-term results, with less morbidity and fewer complications than traditional anteroposterior surgery select patients with thoracolumbar/lumbar scoliosis. This study received no funding. No potential conflict of interest-associated bias existed.
AB - Background context: Combined anteroposterior spinal fusion with instrumentation has been used for many years to treat adult thoracolumbar/lumbar scoliosis. This surgery remains a technical challenge to spine surgeons, and current literature reports high complication rates. Purpose: The purpose of this study is to validate a new hybrid technique (a combination of single-rod anterior instrumentation and a shorter posterior instrumentation to the sacrum) to treat adult thoracolumbar/lumbar scoliosis. Study design: This study is a retrospective consecutive case series of surgically treated patients with adult lumbar or thoracolumbar scoliosis. Patient sample :This is a retrospective study of 33 matched pairs of patients with adult scoliosis who underwent two different surgical procedures: a new hybrid technique versus a third-generation anteroposterior spinal fusion. Outcome measures: Preoperative and postoperative outcome measures include self-report measures, physiological measures, and functional measures. Methods: In a retrospective case-control study, 33 patients treated with the hybrid technique were matched with 33 patients treated with traditional anteroposterior fusion based on preoperative radiographic parameters. Mean follow-up in the hybrid group was 5.3 years (range, 2-11 years), compared with 4.6 years (range, 2-10 years) in the control group. Operating room (OR) time, estimated blood loss, and levels fused were collected as surrogates for surgical morbidity. Radiographic parameters were collected preoperatively, postoperatively, and at final follow-up. The Scoliosis Research Society Patient Questionnaire (SRS-22r) and Oswestry Disability Index (ODI) scores were collected for clinical outcomes. Results: Operating room time, EBL, and levels fused were significantly less in the hybrid group compared with the control group (p<.0001). The postoperative thoracic Cobb angle was similar between the hybrid and control techniques (p=.24); however, the hybrid technique showed significant improvement in the thoracolumbar/lumbar curves (p=.004) and the lumbosacral fractional curve (p<.0001). The major complication rate was less in the hybrid group compared with the control group (18% vs. 39%, p=.01). Clinical outcomes at final follow-up were not significantly different based on overall SRS-22r scores and ODI scores. Conclusion: The new hybrid technique demonstrates good long-term results, with less morbidity and fewer complications than traditional anteroposterior surgery select patients with thoracolumbar/lumbar scoliosis. This study received no funding. No potential conflict of interest-associated bias existed.
KW - Adult idiopathic degenerative scoliosis
KW - Anterior instrumentation
KW - Anteroposterior spinal fusion
KW - Long posterior spinal instrumentation
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UR - http://www.scopus.com/inward/citedby.url?scp=84897086129&partnerID=8YFLogxK
U2 - 10.1016/j.spinee.2013.06.090
DO - 10.1016/j.spinee.2013.06.090
M3 - Article
VL - 14
SP - 637
EP - 645
JO - Spine Journal
JF - Spine Journal
SN - 1529-9430
IS - 4
ER -