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Ehlers-Danlos Syndrome is Associated with Increased Rates of Adjacent Segment Disease Following TLIF: A Propensity Matched Study – Lumbar Fusion

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This article discusses the implications of Ehlers-Danlos syndrome (EDS) on the risk of adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF), which is a surgical procedure for degenerative disc disease. The study compared the rates of ASD between patients with EDS and those without EDS. Using a database of patients who underwent TLIF, the researchers performed propensity matching to control for confounding variables. The results showed that patients with EDS were more likely to experience ASD after TLIF compared to those without EDS. However, there was no significant difference between the two patient groups in terms of a diagnosis of pseudoarthrosis or medical and surgical complications. The study suggests that EDS may be associated with an increased risk of ASD following TLIF, but further research is needed to confirm these findings

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

: After propensity matching to control for confounding variables, the findings of this study suggest that EDS may be associated with an increased risk of ASD following TLIF. Future studies are needed to corroborate these findings.

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World Neurosurg. 2023 Nov 2:S1878-8750(23)01540-1. doi: 10.1016/j.wneu.2023.10.134. Online ahead of print.ABSTRACTBACKGROUND: Ehlers-Danlos syndrome (EDS) is a collection of connective tissue disorders which are often associated with tissue laxity and disc degeneration. However, the implications of EDS on the risk of adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) are not well described.OBJECTIVE: The,

World Neurosurg. 2023 Nov 2:S1878-8750(23)01540-1. doi: 10.1016/j.wneu.2023.10.134. Online ahead of print.

ABSTRACT

BACKGROUND: Ehlers-Danlos syndrome (EDS) is a collection of connective tissue disorders which are often associated with tissue laxity and disc degeneration. However, the implications of EDS on the risk of adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) are not well described.

OBJECTIVE: The objective of this study is to compare the rates of ASD among patients with EDS and those without EDS.

DESIGN: Setting, Participants: Patients who underwent 1-3 level TLIF for degenerative disc disease between 2010-2022 were identified using the PearlDiver Mariner all-claims insurance database. Patients with all types of EDS were included. Patients undergoing surgery for tumors, trauma, or infection were excluded. 1:1 propensity matching was performed using demographic factors, medical comorbidities, and surgical factors which were significantly associated with ASD in a linear regression model.

MAIN OUTCOMES AND MEASURES: The primary outcome measure was development of ASD. The secondary outcomes were the development of pseudoarthrosis, medical complications, and surgical complications.

RESULTS: Propensity matching resulted in two equal groups of 85 patients who did or did have EDS and underwent 1-3 level TLIF. Patients without EDS were less likely to experience ASD (RR 0.18, 95% CI 0.09-0.35, p<0.001). There was no significant difference between the two patient groups with regards to a diagnosis of pseudoarthrosis, and there was no significant difference for all-cause medical and surgical complications between the two patient groups.

: After propensity matching to control for confounding variables, the findings of this study suggest that EDS may be associated with an increased risk of ASD following TLIF. Future studies are needed to corroborate these findings.

PMID:37925152 | DOI:10.1016/j.wneu.2023.10.134

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Ehlers-Danlos Syndrome is Associated with Increased Rates of Adjacent Segment Disease Following TLIF: A Propensity Matched Study

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World Neurosurg. 2023 Nov 2:S1878-8750(23)01540-1. doi: 10.1016/j.wneu.2023.10.134. Online ahead of print.ABSTRACTBACKGROUND: Ehlers-Danlos syndrome (EDS) is a collection of connective tissue disorders which are often associated with tissue laxity and disc degeneration. However, the implications of EDS on the risk of adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) are not well described.OBJECTIVE: The

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