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The article compared perioperative outcomes and costs of staged (ST) and same-day (SD) circumferential adult spinal deformity (ASD) corrective surgeries. The study included a total of 211 patients, with 50 undergoing ST procedures and 161 undergoing SD procedures. After adjusting for patient characteristics and comorbidities using inverse probability weighting (IPW), the results showed that ST procedures were associated with a significantly increased length of stay, a higher risk of pulmonary embolism, and higher admission costs compared to SD procedures. However, there were no significant differences between the groups in terms of disposition, 30-day readmissions, and reoperations
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most experienced day surgery hospital in UK
Published article
S: Adjusted comparisons between ST and SD groups showed staging associated with significantly increased length of stay, risk of pulmonary embolism, and admission costs.
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Int J Spine Surg. 2023 Oct 12:8548. doi: 10.14444/8548. Online ahead of print.ABSTRACTBACKGROUND: Patients often undergo circumferential (anterior and posterior) spinal fusions to maximize adult spinal deformity (ASD) correction and achieve adequate fusion. Currently, such procedures are performed in staged (ST) or same-day (SD) procedures with limited evidence to support either strategy. This study aims,
Int J Spine Surg. 2023 Oct 12:8548. doi: 10.14444/8548. Online ahead of print.
ABSTRACT
BACKGROUND: Patients often undergo circumferential (anterior and posterior) spinal fusions to maximize adult spinal deformity (ASD) correction and achieve adequate fusion. Currently, such procedures are performed in staged (ST) or same-day (SD) procedures with limited evidence to support either strategy. This study aims to compare perioperative outcomes and costs of ST vs SD circumferential ASD corrective surgeries.
METHODS: This is a retrospective review of patients undergoing circumferential ASD surgeries between 2013 and 2018 in a single institution. Patient characteristics, preoperative comorbidities, surgical details, perioperative complications, readmissions, total hospital admission costs, and 90-day postoperative care costs were identified. All variables were tested for differences between ST and SD groups unadjusted and after applying inverse probability weighting (IPW), and the results before and after IPW were compared.
RESULTS: The entire cohort included a total of 211 (ST = 50, SD = 161) patients, 100 of whom (ST = 44, SD = 56) underwent more than 4 levels fused posteriorly and anterior lumbar interbody fusion (ALIF). Although patient characteristics and comorbidities were not dissimilar between the ST and SD groups, both the number of levels fused in ALIF and posterior spinal fusion (PSF) were significantly different. Thus, using IPW, we were able to minimize the cohort incongruities in the number of levels fused in ALIF and PSF while maintaining comparable patient characteristics. In both the whole cohort and the long segment fusions, postoperative pulmonary embolism was more common in ST procedures. After adjustment utilizing IPW, both groups were not significantly different in disposition, 30-day readmissions, and reoperations. However, within the whole cohort and the long segment fusion cohort, the ST group continued to show significantly increased rates of pulmonary embolism, longer length of stay, and higher hospital admission costs compared with the SD group.
S: Adjusted comparisons between ST and SD groups showed staging associated with significantly increased length of stay, risk of pulmonary embolism, and admission costs.
PMID:37827708 | DOI:10.14444/8548
The London Spine Unit : most experienced day surgery hospital in UK
Read the original publication:
Comparison of Staged vs Same-Day Circumferential Spinal Fusions for Adult Spinal Deformity
