Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery. / Denisov, Anton; Rowland, Andrea; Zaborovskii, Nikita; Ptashnikov, Dmitrii; Kondrashov, Dimitriy.
In: European Spine Journal, Vol. 33, No. 2, 02.2024, p. 620-629.Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Moderate sagittal plane deformity patients have similar radiographic and functional outcomes with either anterior or posterior surgery
AU - Denisov, Anton
AU - Rowland, Andrea
AU - Zaborovskii, Nikita
AU - Ptashnikov, Dmitrii
AU - Kondrashov, Dimitriy
N1 - © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2024/2
Y1 - 2024/2
N2 - PURPOSE: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation (TLIF-Schwab2).METHODS: A retrospective cohort study included 61 ASD patients treated surgically between 2019 and 2020 at a single tertiary orthopedic specialty hospital. Patients were divided into two groups: Group 1 (ALIF-ACR, 29 patients) and Group 2 (TLIF-Schwab2, 32 patients). Spinopelvic radiographic parameters and functional outcomes were evaluated at 3, 6, and 12 months postsurgery.RESULTS: Perioperative outcomes favored the ALIF-ACR group, with significantly smaller blood loss, shorter hospital stay, and operative time. Radiographic and functional outcomes were similar for both groups; however, the ALIF-ACR group did have a greater degree of correction in lumbar lordosis at 12 months. Complication profiles varied, with the ALIF-ACR group experiencing mostly hardware-related complications, while the TLIF-Schwab2 group faced dural tears, wound dehiscence, and proximal junctional kyphosis. Both groups had similar revision rates.CONCLUSION: Both ALIF-ACR and TLIF-Schwab2 achieved similar radiographic and functional outcomes in ASD patients with moderate sagittal plane deformity at 1-year follow-up. However, the safety profiles of the two techniques differed. Further research is required to optimize patient selection for each surgical approach, aiming to minimize perioperative complications and reoperation rates in this challenging patient population.
AB - PURPOSE: This study aimed to compare the functional and radiographic outcomes of two surgical interventions for adult spinal deformity (ASD): anterior lumbar interbody fusion with anterior column realignment (ALIF-ACR) and posterior approach using Smith-Peterson osteotomy with transforaminal lumbar interbody fusion and pedicle screw fixation (TLIF-Schwab2).METHODS: A retrospective cohort study included 61 ASD patients treated surgically between 2019 and 2020 at a single tertiary orthopedic specialty hospital. Patients were divided into two groups: Group 1 (ALIF-ACR, 29 patients) and Group 2 (TLIF-Schwab2, 32 patients). Spinopelvic radiographic parameters and functional outcomes were evaluated at 3, 6, and 12 months postsurgery.RESULTS: Perioperative outcomes favored the ALIF-ACR group, with significantly smaller blood loss, shorter hospital stay, and operative time. Radiographic and functional outcomes were similar for both groups; however, the ALIF-ACR group did have a greater degree of correction in lumbar lordosis at 12 months. Complication profiles varied, with the ALIF-ACR group experiencing mostly hardware-related complications, while the TLIF-Schwab2 group faced dural tears, wound dehiscence, and proximal junctional kyphosis. Both groups had similar revision rates.CONCLUSION: Both ALIF-ACR and TLIF-Schwab2 achieved similar radiographic and functional outcomes in ASD patients with moderate sagittal plane deformity at 1-year follow-up. However, the safety profiles of the two techniques differed. Further research is required to optimize patient selection for each surgical approach, aiming to minimize perioperative complications and reoperation rates in this challenging patient population.
KW - Adult
KW - Animals
KW - Humans
KW - Lumbar Vertebrae/diagnostic imaging
KW - Retrospective Studies
KW - Spinal Fusion
KW - Head
KW - Kyphosis/diagnostic imaging
KW - Ponte osteotomy
KW - Smith–Petersen osteotomy
KW - Adult spinal deformity
KW - Surgical outcome
KW - ACR
KW - TLIF
KW - ALIF
UR - https://www.mendeley.com/catalogue/46198f4f-2b1c-3ac8-b957-b600a512ab6f/
U2 - 10.1007/s00586-023-08075-8
DO - 10.1007/s00586-023-08075-8
M3 - Article
C2 - 38151636
VL - 33
SP - 620
EP - 629
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
IS - 2
ER -
ID: 118586607