The article discusses the impact of delayed posterior augmentation on outcomes in patients undergoing circumferential minimally invasive scoliosis surgeries. The study included a retrospective review of patients from 2006 to 2019 who had their planned posterior fixation postponed due to medical necessity or safety concerns. Three out of six patients did not undergo posterior augmentation due to symptomatic improvement during follow-up periods ranging from 2.3 to 10.7 years. The other three patients underwent posterior fixation after being medically optimized, with an average interval of 4.7 months. It was observed that the group requiring further fixation had a higher average coronal malalignment in the postoperative period compared to the group that did not require it. The study suggests that in select cases, minimally invasive anterolateral arthrodesis alone may provide enough pain relief to delay or avoid posterior fixation in adult spinal deformity patients
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised day surgery spinal centre on Harley Street UK
Published article
CONCLUSION: 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.
Lumbar Decompression Surgery Expert. Best Spinal Surgeon UK
Spine Deform. 2023 Aug 1. doi: 10.1007/s43390-023-00725-7. Online ahead of print.ABSTRACTPURPOSE: 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,
Spine Deform. 2023 Aug 1. doi: 10.1007/s43390-023-00725-7. Online ahead of print.
ABSTRACT
PURPOSE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSION: 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.
PMID:37525061 | DOI:10.1007/s43390-023-00725-7
The London Spine Unit : best recognised day surgery spinal centre on Harley Street UK
Read the original publication:
Durability of stand-alone anterolateral interbody fusion in staged minimally invasive circumferential scoliosis surgery with delayed posterior instrumentation due to medical necessity
