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Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis

BACKGROUND: Low back pain from lumbar spondylosis affects a large proportion of the population. In select cases, lumbar fusion may be considered. However, cohort studies have not shown clear differences in long-term outcomes between PSF, TLIF, ALIF, and AP fusion. Thus, differences in perioperative...

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Autores principales: Gala, Raj J, Ottesen, Taylor D, Kahan, Joseph B, Varthi, Arya G, Grauer, Jonathan N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820031/
https://www.ncbi.nlm.nih.gov/pubmed/35141578
http://dx.doi.org/10.1016/j.xnsj.2020.100005
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author Gala, Raj J
Ottesen, Taylor D
Kahan, Joseph B
Varthi, Arya G
Grauer, Jonathan N
author_facet Gala, Raj J
Ottesen, Taylor D
Kahan, Joseph B
Varthi, Arya G
Grauer, Jonathan N
author_sort Gala, Raj J
collection PubMed
description BACKGROUND: Low back pain from lumbar spondylosis affects a large proportion of the population. In select cases, lumbar fusion may be considered. However, cohort studies have not shown clear differences in long-term outcomes between PSF, TLIF, ALIF, and AP fusion. Thus, differences in perioperative complications might affect choice between these procedures for the given diagnosis. The current study seeks to compare perioperative adverse events for patients with lumbar spondylosis treated with single-level: posterior spinal fusion (PSF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), or combined anterior and posterior lumbar fusion (AP fusion). METHODS: Patients with a diagnosis of lumbar spondylosis who underwent single-level lumbar fusion without decompression were identified in the 2010-2016 National Quality Improvement Program (NSQIP) database. Patients were categorized based on their procedure (PSF, TLIF, ALIF, or AP fusion). Unadjusted Fisher's exact and Pearson's chi-squared tests were used to compare demographics and comorbid factors. Analysis was secondarily done with propensity score matching to address potential differences in patient selection between the study cohorts. RESULTS: In total, 1816 patients were identified: PSF n=322, TLIF n=800, ALIF n=460, AP fusion n=234. The procedures did not have different thirty-day individual or aggregated (any, serious, minor, or infection) adverse events. Further, propensity score matched analysis also revealed no differences in individual or aggregated thirty-day perioperative events. CONCLUSION: The current study demonstrates a lack of difference in thirty-day perioperative adverse events for different fusion procedures performed for lumbar spondylosis, consistent with prior longer-term outcome studies. These findings suggest that patient/surgeon preference and other factors not captured here should be considered to determine the best surgical technique for the select patients with the given diagnosis who are considered for lumbar fusion. SUMMARY SENTENCE: Using the NSQIP 2010-2016 databases, this study showed that perioperative adverse events were similar for different surgical approaches of single-level fusion for single-level lumbar spondylosis.
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spelling pubmed-88200312022-02-08 Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis Gala, Raj J Ottesen, Taylor D Kahan, Joseph B Varthi, Arya G Grauer, Jonathan N N Am Spine Soc J Clinical Studies BACKGROUND: Low back pain from lumbar spondylosis affects a large proportion of the population. In select cases, lumbar fusion may be considered. However, cohort studies have not shown clear differences in long-term outcomes between PSF, TLIF, ALIF, and AP fusion. Thus, differences in perioperative complications might affect choice between these procedures for the given diagnosis. The current study seeks to compare perioperative adverse events for patients with lumbar spondylosis treated with single-level: posterior spinal fusion (PSF), transforaminal lumbar interbody fusion (TLIF), anterior lumbar interbody fusion (ALIF), or combined anterior and posterior lumbar fusion (AP fusion). METHODS: Patients with a diagnosis of lumbar spondylosis who underwent single-level lumbar fusion without decompression were identified in the 2010-2016 National Quality Improvement Program (NSQIP) database. Patients were categorized based on their procedure (PSF, TLIF, ALIF, or AP fusion). Unadjusted Fisher's exact and Pearson's chi-squared tests were used to compare demographics and comorbid factors. Analysis was secondarily done with propensity score matching to address potential differences in patient selection between the study cohorts. RESULTS: In total, 1816 patients were identified: PSF n=322, TLIF n=800, ALIF n=460, AP fusion n=234. The procedures did not have different thirty-day individual or aggregated (any, serious, minor, or infection) adverse events. Further, propensity score matched analysis also revealed no differences in individual or aggregated thirty-day perioperative events. CONCLUSION: The current study demonstrates a lack of difference in thirty-day perioperative adverse events for different fusion procedures performed for lumbar spondylosis, consistent with prior longer-term outcome studies. These findings suggest that patient/surgeon preference and other factors not captured here should be considered to determine the best surgical technique for the select patients with the given diagnosis who are considered for lumbar fusion. SUMMARY SENTENCE: Using the NSQIP 2010-2016 databases, this study showed that perioperative adverse events were similar for different surgical approaches of single-level fusion for single-level lumbar spondylosis. Elsevier 2020-05-18 /pmc/articles/PMC8820031/ /pubmed/35141578 http://dx.doi.org/10.1016/j.xnsj.2020.100005 Text en © 2020 The Authors. Published by Elsevier Ltd on behalf of North American Spine Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Clinical Studies
Gala, Raj J
Ottesen, Taylor D
Kahan, Joseph B
Varthi, Arya G
Grauer, Jonathan N
Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title_full Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title_fullStr Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title_full_unstemmed Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title_short Perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
title_sort perioperative adverse events after different fusion approaches for single-level lumbar spondylosis
topic Clinical Studies
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8820031/
https://www.ncbi.nlm.nih.gov/pubmed/35141578
http://dx.doi.org/10.1016/j.xnsj.2020.100005
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