Preoperative full-length standing radiographs and revision charges in lumbar degenerative scoliosis.
J Neurosurg Backbone. 2018 Mar 23;:1-5
Authors: Bunch JT, Glassman SD, Underwood HR, Metcalfe LN, Ondra S, Vasilyev I, Carreon LY
OBJECTIVE Full-length (36-inch) standing backbone radiographs are generally utilized by backbone surgeons to judge sufferers with lumbar degenerative scoliosis (LDS). Regardless of this observe, the impression of those photographs on preoperative choice making and the speed of revision surgical procedure has not been analyzed. The aim of this examine is to find out if preoperative full-length standing backbone radiographs enhance surgical choice making by lowering the speed of revision surgical procedure in sufferers with LDS. METHODS From the Well being Care Service Company administrative claims database, the authors recognized sufferers 50-80 years of age with LDS who had undergone surgical procedure together with posterior lumbar decompression and fusion over 2-6 ranges and with no less than 5 years of steady protection after the index surgical procedure. Sufferers have been stratified into the next teams, in keeping with the preoperative imaging research carried out inside 6 months earlier than their index surgical procedure: lumbar backbone MRI research solely, lumbar backbone MRI research and commonplace lumbar backbone radiographs, CT myelograms, and full-length standing backbone radiographs. Survival evaluation was carried out with the incidence of a revision inside 5 years of the index surgical procedure as the result of curiosity. RESULTS A complete of 411 sufferers have been included within the examine after making use of the inclusion and exclusion standards. Revision surgical procedure inside 5 years after the index process was most frequent within the sufferers with preoperative MRI solely (41.eight%), adopted by the sufferers with a CT myelogram (30.four%) and people with MRI and commonplace radiographs (24.eight%). The bottom revision price was seen amongst these with long-cassette standing radiographs (11.1%). Sufferers whose preoperative analysis included full-length standing radiographs (OR zero.353, p = zero.034) and MRI research plus radiographs (OR zero.650, p = zero.022) have been much less prone to require revision surgical procedure at 5 years after the index process. CONCLUSIONS An evaluation of standing alignment utilizing full-length (36-inch) standing radiographs could also be helpful in lowering the chance of revision surgical procedure in sufferers with lumbar scoliosis. This remark was not restricted to sufferers with giant curves or substantial deformity.
PMID: 29570045 [PubMed – as supplied by publisher]