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Long-term Outcomes After Adult Spinal Deformity Surgery Using Lateral Interbody Fusion: Short Versus Long Fusion – Lumbar Fusion

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The article is a retrospective cohort study investigating long-term outcomes after short or long fusion for adult spinal deformity using lateral interbody fusion. The study found that short fusion may be an option for patients without degenerative changes at the thoracolumbar junction, as it showed similar health-related quality of life maintenance between 2- and 5-year follow-up compared to long fusion. However, there was correction loss in the short fusion group within 2 years postoperatively, and certain outcome measures, such as Oswestry Disability Index and Scoliosis Research Society scores, were significantly different between the two groups at the 5-year follow-up. Overall, the study suggests that lateral interbody fusion may allow for the selection of short fusion techniques in adult spinal deformity surgery

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : top spinal hospital in London

Published article

S: Health-related quality of life was maintained between 2- and 5-year follow-up in both groups. Short fusion may be an option for patients without degenerative changes at the thoracolumbar junction.

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Clin Spine Surg. 2024 Feb 16. doi: 10.1097/BSD.0000000000001583. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: To investigate long-term outcomes after short or long fusion for adult spinal deformity using lateral interbody fusion.SUMMARY OF BACKGROUND DATA: Lateral interbody fusion is commonly used in adult spinal deformity surgery. Favorable short-term outcomes have been reported, but not,

Clin Spine Surg. 2024 Feb 16. doi: 10.1097/BSD.0000000000001583. Online ahead of print.

ABSTRACT

STUDY DESIGN: Retrospective cohort study.

OBJECTIVE: To investigate long-term outcomes after short or long fusion for adult spinal deformity using lateral interbody fusion.

SUMMARY OF BACKGROUND DATA: Lateral interbody fusion is commonly used in adult spinal deformity surgery. Favorable short-term outcomes have been reported, but not long-term outcomes. Lateral interbody fusion with strong ability to correct deformity may allow the selection of short fusion techniques.

MATERIALS AND METHODS: We retrospectively reviewed adults who underwent this surgery with a minimum of 5 years of follow-up. Short fusion with the uppermost instrumented vertebra in the lumbar spine was performed in patients without degenerative changes at the thoracolumbar junction (S-group); others underwent long fusion with the uppermost instrumented vertebra in the thoracic spine (L-group). We assessed radiographic and clinical outcomes.

RESULTS: Short fusion was performed in 29 of 54 patients. One patient per group required revision surgery. Of the remainder, with similar preoperative characteristics and deformity correction between groups, correction loss (pelvic incidence-lumbar lordosis, P=0.003; pelvic tilt, P=0.005; sagittal vertical axis, P˂0.001) occurred within 2 years postoperatively in the S-group, and sagittal vertical axis continued to increase until the 5-year follow-up (P=0.021). Although there was a significant change in Oswestry disability index in the S-group (P=0.031) and self-image of Scoliosis Research Society 22r score in both groups (P=0.045 and 0.02) from 2- to 5-year follow-up, minimum clinically important differences were not reached. At 5-year follow-up, there was a significant difference in Oswestry Disability Index (P=0.013) and Scoliosis Research Society 22r scores (function: P=0.028; pain: P=0.003; subtotal: P=0.006) between the groups, but satisfaction scores were comparable and Oswestry Disability Index score (29.8%) in the S-group indicated moderate disability.

S: Health-related quality of life was maintained between 2- and 5-year follow-up in both groups. Short fusion may be an option for patients without degenerative changes at the thoracolumbar junction.

LEVEL OF EVIDENCE: III.

PMID:38366331 | DOI:10.1097/BSD.0000000000001583

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Long-term Outcomes After Adult Spinal Deformity Surgery Using Lateral Interbody Fusion: Short Versus Long Fusion

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Clin Spine Surg. 2024 Feb 16. doi: 10.1097/BSD.0000000000001583. Online ahead of print.ABSTRACTSTUDY DESIGN: Retrospective cohort study.OBJECTIVE: To investigate long-term outcomes after short or long fusion for adult spinal deformity using lateral interbody fusion.SUMMARY OF BACKGROUND DATA: Lateral interbody fusion is commonly used in adult spinal deformity surgery. Favorable short-term outcomes have been reported, but not

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