Cargando…

Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis

STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes bet...

Descripción completa

Detalles Bibliográficos
Autores principales: Van Halm-Lutterodt, Nicholas Ishmael, Al-Saidi, Neil Nazar, Mandalia, Krishna, Mesregah, Mohamed Kamal, Ghanem, Kristina Marie, Storlie, Nicholas Robert, Huang, Wei-Hsun, Chen, Wei-Cheng, Bartels-Mensah, Mercy, Chen, Xin Yuan, Ye, Ziyang, Zhang, Yangpu, Pan, Aixing, Kim, Sunny Sik, Lonner, Baron, Alanay, Ahmet, Hai, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448105/
https://www.ncbi.nlm.nih.gov/pubmed/36548436
http://dx.doi.org/10.1177/21925682221146502
_version_ 1785094655010930688
author Van Halm-Lutterodt, Nicholas Ishmael
Al-Saidi, Neil Nazar
Mandalia, Krishna
Mesregah, Mohamed Kamal
Ghanem, Kristina Marie
Storlie, Nicholas Robert
Huang, Wei-Hsun
Chen, Wei-Cheng
Bartels-Mensah, Mercy
Chen, Xin Yuan
Ye, Ziyang
Zhang, Yangpu
Pan, Aixing
Kim, Sunny Sik
Lonner, Baron
Alanay, Ahmet
Hai, Yong
author_facet Van Halm-Lutterodt, Nicholas Ishmael
Al-Saidi, Neil Nazar
Mandalia, Krishna
Mesregah, Mohamed Kamal
Ghanem, Kristina Marie
Storlie, Nicholas Robert
Huang, Wei-Hsun
Chen, Wei-Cheng
Bartels-Mensah, Mercy
Chen, Xin Yuan
Ye, Ziyang
Zhang, Yangpu
Pan, Aixing
Kim, Sunny Sik
Lonner, Baron
Alanay, Ahmet
Hai, Yong
author_sort Van Halm-Lutterodt, Nicholas Ishmael
collection PubMed
description STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes between those classified osteotomy approaches. METHODS: Thorough literature review and meta-analysis were conducted between January 2000 and September 2021. The selection criteria were studies: i) reporting major curve Cobb angle of ≥80° and flexibility of <25% or 30%; ii) comparing VCR or ≥ Type V Schwab osteotomy defined as VCR-based vs [non-VCR-based] techniques, (any osteotomy or technique other than VCR); iii) published in English with ≥10 patients; iv) reporting complication rates; and v) having minimum of 2-year follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Significance level was set at (P < .05). RESULTS: Of the 174 patients included, 52.30% (n = 91) and 47.70% (n = 83) were VCR-based and non-VCR-based, respectively. The incidence of dural tears/nerve injuries/significant intraoperative-neuromonitoring changes was significantly higher; [OR = 6.78, CI= (1.75 to 26.17), I2 = 0%, (P = .006)] in the VCR-based group than the non-VCR-based group. The ‘overall surgical and medical’ complication rate was significantly higher in the VCR-based group, [OR = 1.94, CI= (1.02 to 3.67), I2 = 31%, (P = .04)]. CONCLUSION: Both VCR-based and non-VCR-based surgical techniques for management of severe rigid scoliosis and kyphoscoliosis patients pose comparable overall surgical complication rates, while a significantly higher perioperative neurological complication incidence was associated with VCR-based technique compared to the non-VCR-based techniques. The VCR-based technique was associated with 6.78 times higher incidence of neurological complications compared to non-VCR-based techniques.
format Online
Article
Text
id pubmed-10448105
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher SAGE Publications
record_format MEDLINE/PubMed
spelling pubmed-104481052023-08-25 Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis Van Halm-Lutterodt, Nicholas Ishmael Al-Saidi, Neil Nazar Mandalia, Krishna Mesregah, Mohamed Kamal Ghanem, Kristina Marie Storlie, Nicholas Robert Huang, Wei-Hsun Chen, Wei-Cheng Bartels-Mensah, Mercy Chen, Xin Yuan Ye, Ziyang Zhang, Yangpu Pan, Aixing Kim, Sunny Sik Lonner, Baron Alanay, Ahmet Hai, Yong Global Spine J Review Articles STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes between those classified osteotomy approaches. METHODS: Thorough literature review and meta-analysis were conducted between January 2000 and September 2021. The selection criteria were studies: i) reporting major curve Cobb angle of ≥80° and flexibility of <25% or 30%; ii) comparing VCR or ≥ Type V Schwab osteotomy defined as VCR-based vs [non-VCR-based] techniques, (any osteotomy or technique other than VCR); iii) published in English with ≥10 patients; iv) reporting complication rates; and v) having minimum of 2-year follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Significance level was set at (P < .05). RESULTS: Of the 174 patients included, 52.30% (n = 91) and 47.70% (n = 83) were VCR-based and non-VCR-based, respectively. The incidence of dural tears/nerve injuries/significant intraoperative-neuromonitoring changes was significantly higher; [OR = 6.78, CI= (1.75 to 26.17), I2 = 0%, (P = .006)] in the VCR-based group than the non-VCR-based group. The ‘overall surgical and medical’ complication rate was significantly higher in the VCR-based group, [OR = 1.94, CI= (1.02 to 3.67), I2 = 31%, (P = .04)]. CONCLUSION: Both VCR-based and non-VCR-based surgical techniques for management of severe rigid scoliosis and kyphoscoliosis patients pose comparable overall surgical complication rates, while a significantly higher perioperative neurological complication incidence was associated with VCR-based technique compared to the non-VCR-based techniques. The VCR-based technique was associated with 6.78 times higher incidence of neurological complications compared to non-VCR-based techniques. SAGE Publications 2022-12-22 2023-07 /pmc/articles/PMC10448105/ /pubmed/36548436 http://dx.doi.org/10.1177/21925682221146502 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review Articles
Van Halm-Lutterodt, Nicholas Ishmael
Al-Saidi, Neil Nazar
Mandalia, Krishna
Mesregah, Mohamed Kamal
Ghanem, Kristina Marie
Storlie, Nicholas Robert
Huang, Wei-Hsun
Chen, Wei-Cheng
Bartels-Mensah, Mercy
Chen, Xin Yuan
Ye, Ziyang
Zhang, Yangpu
Pan, Aixing
Kim, Sunny Sik
Lonner, Baron
Alanay, Ahmet
Hai, Yong
Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title_full Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title_fullStr Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title_full_unstemmed Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title_short Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients: A Systematic Review and Meta-Analysis
title_sort comparison of overall complication rates in vcr-based vs non-vcr-based corrective techniques in severe rigid kyphoscoliosis patients: a systematic review and meta-analysis
topic Review Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10448105/
https://www.ncbi.nlm.nih.gov/pubmed/36548436
http://dx.doi.org/10.1177/21925682221146502
work_keys_str_mv AT vanhalmlutterodtnicholasishmael comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT alsaidineilnazar comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT mandaliakrishna comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT mesregahmohamedkamal comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT ghanemkristinamarie comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT storlienicholasrobert comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT huangweihsun comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT chenweicheng comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT bartelsmensahmercy comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT chenxinyuan comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT yeziyang comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT zhangyangpu comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT panaixing comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT kimsunnysik comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT lonnerbaron comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT alanayahmet comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT haiyong comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis
AT comparisonofoverallcomplicationratesinvcrbasedvsnonvcrbasedcorrectivetechniquesinsevererigidkyphoscoliosispatientsasystematicreviewandmetaanalysis