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 -