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Benchmark Values for Construct Survival and Complications by Type of ASD Surgery – Lumbar Fusion

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The article presents a study that aimed to provide benchmarks for the rates of complications based on the type of surgery performed in patients with adult spinal deformity (ASD). The research, conducted using a prospective multicenter database, focused on eight surgical scenarios representing the majority of cases in the cohort. The results showed that there was a significant difference in survival rates for major complications among different surgical types, with fusion procedures short of the pelvis having the best survival rate and UT-Pelvis with 3-column osteotomy (3CO) having the worst. The study suggests that there is an inherent increased risk of complication for some types of ASD surgery, independent of patient profile. The findings can be used to create a surgery-adjusted benchmark for complications and survival in ASD surgery, aiding in surgical decision-making and patient counseling

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: This study suggests that there is an inherent increased risk of complication for some types of ASD surgery independent of patient profile. The results of this paper can be used to produce a surgery-adjusted benchmark for ASD surgery with regard to complications and survival. Such a tool can have very impactful applications for surgical decision making and more informed patient counseling.

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Spine (Phila Pa 1976). 2024 Apr 15. doi: 10.1097/BRS.0000000000005012. Online ahead of print. ABSTRACT OBJECTIVE: Provide benchmarks for the rates of complications by type of surgery performed. STUDY DESIGN: Prospective multicenter database. BACKGROUND: We have previously examined overall construct survival and complication rates for ASD surgery. However, the relationship between type of surgery and construct,

Spine (Phila Pa 1976). 2024 Apr 15. doi: 10.1097/BRS.0000000000005012. Online ahead of print.

ABSTRACT

OBJECTIVE: Provide benchmarks for the rates of complications by type of surgery performed.

STUDY DESIGN: Prospective multicenter database.

BACKGROUND: We have previously examined overall construct survival and complication rates for ASD surgery. However, the relationship between type of surgery and construct survival warrants more detailed assessment.

METHODS: Eight surgical scenarios were defined based on the levels treated, previous fusion status (primary [P] vs. revision [R]), and 3-column osteotomy use [3CO]: Short Lumbar fusion, LT-Pelvis with 5-12 levels treated (P, R or 3CO), UT-Pelvis with  13 levels treated (P, R or 3CO), and Thoracic to Lumbar fusion without pelvic fixation, representing 92.4% of the case in the cohort. Complication rates for each type were calculated and Kaplan Meier curves with multivariate Cox regression analysis was used to evaluate the effect of the case characteristics on construct survival rate, while controlling for patient profile.

RESULTS: 1073 of 1494 patients eligible for 2-year follow-up (71.8%) were captured. Survival curves for major complications (with or without reoperation), while controlling for demographics differed significantly among surgical types (P<0.001). Fusion procedures short of the pelvis had the best survival rate, while UT-Pelvis with 3CO had the worst survival rate. Longer fusions and more invasive operations were associated with lower 2-year complication-free survival, however there were no significant associations between type of surgery and renal, cardiac, infection, wound, gastrointestinal, pulmonary, implant malposition or neurologic complications (all P>0.5).

: This study suggests that there is an inherent increased risk of complication for some types of ASD surgery independent of patient profile. The results of this paper can be used to produce a surgery-adjusted benchmark for ASD surgery with regard to complications and survival. Such a tool can have very impactful applications for surgical decision making and more informed patient counseling.

PMID:38616765 | DOI:10.1097/BRS.0000000000005012

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Benchmark Values for Construct Survival and Complications by Type of ASD Surgery

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Spine (Phila Pa 1976). 2024 Apr 15. doi: 10.1097/BRS.0000000000005012. Online ahead of print. ABSTRACT OBJECTIVE: Provide benchmarks for the rates of complications by type of surgery performed. STUDY DESIGN: Prospective multicenter database. BACKGROUND: We have previously examined overall construct survival and complication rates for ASD surgery. However, the relationship between type of surgery and construct

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