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Effectiveness of a two-stage posterior-anterior-posterior surgery using subcutaneously preserved autologous bone grafts for adult spinal deformity: a retrospective observational study – Lumbar Fusion

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The article discusses a study that compares the effectiveness of a two-stage posterior-anterior-posterior (PAP) surgery versus single-stage anterior-posterior (AP) surgery for correcting rigid kyphoscoliosis. The study involved patients with adult spinal deformity (ASD) and a minimum 2-year follow-up. The two-stage PAP surgery involved the preservation of autologous bone grafts, which were retrieved and used as an autograft for lateral lumbar interbody fusion. The results showed that the PAP group had significantly less blood loss volume and larger postoperative changes in radiological parameters compared to the AP group. The overall complication rate did not differ significantly between the two groups, indicating that the two-stage PAP surgery provided effective correction of rigid kyphoscoliosis without increasing blood loss and postoperative complication rates

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Published article

: Two-stage PAP surgery provided effective correction of rigid kyphoscoliosis without increasing blood loss and postoperative complication rates.

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J Orthop Surg Res. 2024 Jan 27;19(1):91. doi: 10.1186/s13018-024-04572-8.ABSTRACTBACKGROUND: To achieve optimal correction of rigid kyphoscoliosis, we developed a novel two-stage posterior-anterior-posterior (PAP) surgery using subcutaneously preserved autologous bone grafts. This study aimed to investigate the effectiveness of two-stage PAP surgery versus single-stage anterior-posterior (AP) surgery.METHODS: This was a retrospective analysis of patients undergoing combined,

J Orthop Surg Res. 2024 Jan 27;19(1):91. doi: 10.1186/s13018-024-04572-8.

ABSTRACT

BACKGROUND: To achieve optimal correction of rigid kyphoscoliosis, we developed a novel two-stage posterior-anterior-posterior (PAP) surgery using subcutaneously preserved autologous bone grafts. This study aimed to investigate the effectiveness of two-stage PAP surgery versus single-stage anterior-posterior (AP) surgery.

METHODS: This was a retrospective analysis of patients undergoing combined anterior-posterior long-level fusion for adult spinal deformity (ASD) with a minimum 2-year follow-up. The indications for two-stage PAP surgery were rigid thoracolumbar deformity associated with hypertrophic facet arthritis and/or a large pelvic incidence-lumbar lordosis mismatch of > 25°. In the first stage of PAP surgery, pedicle screw insertion and multilevel Ponte osteotomies were performed. The resected local bone was embedded under sutured fascia. One week later, the embedded bone was retrieved in the right lateral position and used as an autograft for lateral lumbar interbody fusion. Final deformity correction was performed in the prone position.

RESULTS: From January 2018 to April 2021, 12 and 16 patients with ASD underwent two-stage PAP surgery (PAP group) and single-stage AP surgery (AP group), respectively. Although PAP surgery was associated with a significantly longer operation time, the total blood loss volume was significantly less in the PAP group than the AP group. Compared with the AP group, the PAP group showed significantly larger postoperative changes in radiological parameters in the sagittal and coronal planes. The overall complication rate did not differ significantly between the two groups.

: Two-stage PAP surgery provided effective correction of rigid kyphoscoliosis without increasing blood loss and postoperative complication rates.

PMID:38281002 | DOI:10.1186/s13018-024-04572-8

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Read the original publication:

Effectiveness of a two-stage posterior-anterior-posterior surgery using subcutaneously preserved autologous bone grafts for adult spinal deformity: a retrospective observational study

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J Orthop Surg Res. 2024 Jan 27;19(1):91. doi: 10.1186/s13018-024-04572-8.ABSTRACTBACKGROUND: To achieve optimal correction of rigid kyphoscoliosis, we developed a novel two-stage posterior-anterior-posterior (PAP) surgery using subcutaneously preserved autologous bone grafts. This study aimed to investigate the effectiveness of two-stage PAP surgery versus single-stage anterior-posterior (AP) surgery.METHODS: This was a retrospective analysis of patients undergoing combined

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