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Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease – Lumbar Fusion

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The article examines the surgical outcomes and risk factors for postoperative mechanical complications in patients with adjacent segment disease (ASD) who undergo fusion surgery. The study retrospectively reviews patients who underwent fusion extension for lumbar ASD from 2011 to 2019. The patients were divided into two groups based on whether their previous implants were removed or preserved during fusion extension. The results showed that both groups had improvements in clinical outcomes, but the group with implant removal had a significantly longer operation time. Mechanical complications occurred more frequently in the group with implant removal, and risk factors for these complications included implant removal, index fusion surgery including L5-S1, and postoperative sagittal malalignment

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Published article

CONCLUSION: Implant removal was a risk factor for mechanical complications. Index fusion surgery including L5-S1 and postoperative sagittal malalignment were also risk factors for mechanical complications.

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Eur Spine J. 2023 Aug 10. doi: 10.1007/s00586-023-07880-5. Online ahead of print.ABSTRACTPURPOSE: Adjacent segment disease (ASD) is a common complication in fusion surgery. In the event of solid segmental fusion, previous implants can be removed or preserved during fusion extension for ASD. To compare the surgical outcomes of patients with and without implants and analyzes,

Eur Spine J. 2023 Aug 10. doi: 10.1007/s00586-023-07880-5. Online ahead of print.

ABSTRACT

PURPOSE: Adjacent segment disease (ASD) is a common complication in fusion surgery. In the event of solid segmental fusion, previous implants can be removed or preserved during fusion extension for ASD. To compare the surgical outcomes of patients with and without implants and analyzes the risk factors for postoperative mechanical complications.

METHODS: Patients who underwent fusion extension for lumbar ASD from 2011 to 2019 with a minimum 2 year follow-up were retrospectively reviewed. Spinopelvic parameters were measured preoperatively and postoperatively. Clinical outcomes and surgical complications were compared between groups with implants preserved and removed. Risk factors for mechanical complications, including clinical, surgical, and radiographic factors were analyzed.

RESULTS: Sixty-nine patients (mean age, 69.9 ± 6.9 years) were included. The mean numbers of initial and extended fused segments were 2.8 ± 0.7 and 2.7 ± 0.7, respectively. Previous implants were removed in 43 patients (R group) and preserved in 26 patients (P group). Both groups showed an improvement in clinical outcomes without between-group differences. The operation time was significantly longer in R group (260 vs 207 min, p < 0.001). Mechanical complications occurred in 13 patients (12 in R group and 1 in P group) and reoperation was needed in 3 patients (R group). Implant removal, index fusion surgery including L5-S1, and postoperative sagittal malalignment were risk factors for mechanical complications.

CONCLUSION: Implant removal was a risk factor for mechanical complications. Index fusion surgery including L5-S1 and postoperative sagittal malalignment were also risk factors for mechanical complications.

PMID:37558910 | DOI:10.1007/s00586-023-07880-5

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Risk factors for mechanical complications after fusion extension surgery for lumbar adjacent segment disease

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Eur Spine J. 2023 Aug 10. doi: 10.1007/s00586-023-07880-5. Online ahead of print.ABSTRACTPURPOSE: Adjacent segment disease (ASD) is a common complication in fusion surgery. In the event of solid segmental fusion, previous implants can be removed or preserved during fusion extension for ASD. To compare the surgical outcomes of patients with and without implants and analyzes

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