Use of the subcutaneous lumbar backbone (SLS) index as a predictor for surgical issues in lumbar backbone surgical procedure.
Backbone J. 2018 Apr 27;:
Authors: Shaw Ok, Chen J, Sheppard W, Alazzeh M, Park H, Park D, Shamie AN
BACKGROUND CONTEXT: Lumbar backbone surgical procedures require satisfactory publicity to visualise key buildings and restricted publicity could make surgical procedure extra technically tough, thus rising the potential for issues. Physique mass index and physique mass distribution have been proven to be related to worse surgical outcomes.
PURPOSE: This research goals to additional earlier investigations in elucidating the predictive nature of physique mass distribution with peri- and post-operative issues in lumbar surgical procedure.
STUDY DESIGN/SETTING: It is a retrospective research carried out at a single establishment.
PATIENT SAMPLE: 285 sufferers who underwent lumbar laminectomy, laminotomy, or posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) procedures between 2013 and 2016.
OUTCOME MEASURES: MRI photos and EMR reviewed for measurements and related issues.
METHODS: Beforehand recognized danger elements had been recognized and MRI measurements of subcutaneous adipose depth (SAD) relative to spinous course of top (SPH) had been measured on the surgical website to generate the Subcutaneous Lumbar Backbone Index (SLS). This measurement was then analyzed in affiliation with recorded surgical issues.
RESULTS: SLS Index was discovered to be a big danger issue for whole issues (Zero.292, p=Zero.041), peri-operative issues (Zero.202, p=Zero.015), and wish for revision surgical procedure (Zero.285, p<Zero.001). Subcutaneous adipose depth alone, proved to be negatively related to peri-operative issues (-Zero.075, p=Zero.034) and wish for revision surgical procedure (-Zero.104, p=Zero.001), with no predictive affiliation seen for whole or post-operative issues. Linear regression revealed an SLS Index of three.43 as a threshold worth related to a better danger for whole issues, 5.eight for perioperative issues, and three.81 for the necessity for revision surgical procedures.
CONCLUSION: Physique mass distribution of the surgical website as indicated by subcutaneous adipose depth to spinous course of top (SLS Index) is considerably related to rising danger for post-operative and peri-operative issues in addition to elevated chance for essential revision surgical procedure. This relationship was proven to be a extra correct indication of peri-operative danger than earlier requirements of BMI and subcutaneous adipose depth alone, and should permit backbone surgeons to evaluate surgical danger when contemplating lumbar backbone surgical procedure utilizing easy calculations from normal pre-operative MRIs.
PMID: 29709549 [PubMed – as supplied by publisher]