Complication Risk in Primary and Revision Minimally Invasive Lumbar Interbody Fusion: A Comparable Alternative to Conventional Open Techniques?
Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients an...
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Published in | Global spine journal Vol. 10; no. 5; pp. 619 - 626 |
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Main Authors | , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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Los Angeles, CA
SAGE Publications
01.08.2020
Sage Publications Ltd |
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Abstract | Study Design:
Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution.
Objective:
To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures.
Methods:
Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate.
Results:
Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P = .682); however, primary cases had longer operative times (301 vs 246 minutes, P = .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P > .05). For open patients, there were no differences between primary and revision cases in EBL (P > .05), although revisions had longer operative times (331 vs 278 minutes, P = .018) and more postoperative complications (61.7% vs 23.8%, P < .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P = .197) with significantly less EBL (294 vs 965 cm3, P < .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P < .05).
Conclusions:
Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. |
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AbstractList | Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution.
To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures.
Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate.
Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm
,
= .682); however, primary cases had longer operative times (301 vs 246 minutes,
= .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all
> .05). For open patients, there were no differences between primary and revision cases in EBL (
> .05), although revisions had longer operative times (331 vs 278 minutes,
= .018) and more postoperative complications (61.7% vs 23.8%,
< .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes,
= .197) with significantly less EBL (294 vs 965 cm
,
< .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all
< .05).
Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. STUDY DESIGNRetrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. OBJECTIVETo assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. METHODSPatients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. RESULTSOf the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P = .682); however, primary cases had longer operative times (301 vs 246 minutes, P = .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P > .05). For open patients, there were no differences between primary and revision cases in EBL (P > .05), although revisions had longer operative times (331 vs 278 minutes, P = .018) and more postoperative complications (61.7% vs 23.8%, P < .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P = .197) with significantly less EBL (294 vs 965 cm3, P < .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P < .05). CONCLUSIONSClinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. Results: Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm 3 , P = .682); however, primary cases had longer operative times (301 vs 246 minutes, P = .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P > .05). For open patients, there were no differences between primary and revision cases in EBL ( P > .05), although revisions had longer operative times (331 vs 278 minutes, P = .018) and more postoperative complications (61.7% vs 23.8%, P < .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P = .197) with significantly less EBL (294 vs 965 cm 3 , P < .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P < .05). Conclusions: Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. Results: Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P = .682); however, primary cases had longer operative times (301 vs 246 minutes, P = .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P > .05). For open patients, there were no differences between primary and revision cases in EBL (P > .05), although revisions had longer operative times (331 vs 278 minutes, P = .018) and more postoperative complications (61.7% vs 23.8%, P < .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P = .197) with significantly less EBL (294 vs 965 cm3, P < .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P < .05). Conclusions: Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To assess differences in perioperative outcomes between primary and revision MIS (minimally invasive surgical) lumbar interbody fusion patients and compare with those undergoing corresponding open procedures. Methods: Patients ≥18 years old undergoing lumbar interbody fusion were grouped by surgical technique: MIS or open. Patients within each group were propensity score matched for comorbidities and levels fused. Patient demographics, surgical factors, and perioperative complication incidences were compared between primary and revision cases using means comparison tests, as appropriate. Results: Of the 214 lumbar interbody fusion patients included after propensity score matching, 44 (21%) cases were MIS, and 170 (79%) were open. For MIS patients, there were no significant differences between primary and revision cases in estimated blood loss (EBL; 344 vs 299 cm3, P = .682); however, primary cases had longer operative times (301 vs 246 minutes, P = .029). There were no differences in length of stay (LOS), intensive care unit LOS, readmission, and intraoperative or postoperative complications (all P > .05). For open patients, there were no differences between primary and revision cases in EBL (P > .05), although revisions had longer operative times (331 vs 278 minutes, P = .018) and more postoperative complications (61.7% vs 23.8%, P < .001). MIS revision procedures were shorter than open revisions (182 vs 213 minutes, P = .197) with significantly less EBL (294 vs 965 cm3, P < .001), shorter inpatient and intensive care unit LOS, and fewer postoperative complications (all P < .05). Conclusions: Clinical outcomes of revision MIS lumbar interbody fusion were similar to those of primary surgery. Additionally, MIS techniques were associated with less EBL, shorter LOS, and fewer perioperative complications than corresponding open revisions. |
Author | Fischer, Charla R. Bortz, Cole Lafage, Virginie Buckland, Aaron J. Sciubba, Daniel M. De La Garza-Ramos, Rafael Gerling, Michael C. Vasquez-Montes, Dennis Protopsaltis, Themistocles S. Ge, David H. Varlotta, Christopher Horn, Samantha R. Brown, Avery E. Pierce, Katherine E. Lafage, Renaud Passias, Peter G. Alas, Haddy Segreto, Frank |
AuthorAffiliation | 3 Johns Hopkins University School of Medicine, Baltimore, MD, USA 2 Hospital for Special Surgery, New York, NY, USA 4 Bronx-Lebanon Hospital Center, New York, NY, USA 1 NYU Langone Orthopedic Hospital, New York, NY, USA |
AuthorAffiliation_xml | – name: 2 Hospital for Special Surgery, New York, NY, USA – name: 1 NYU Langone Orthopedic Hospital, New York, NY, USA – name: 3 Johns Hopkins University School of Medicine, Baltimore, MD, USA – name: 4 Bronx-Lebanon Hospital Center, New York, NY, USA |
Author_xml | – sequence: 1 givenname: Cole surname: Bortz fullname: Bortz, Cole – sequence: 2 givenname: Haddy surname: Alas fullname: Alas, Haddy – sequence: 3 givenname: Frank surname: Segreto fullname: Segreto, Frank – sequence: 4 givenname: Samantha R. surname: Horn fullname: Horn, Samantha R. – sequence: 5 givenname: Christopher surname: Varlotta fullname: Varlotta, Christopher – sequence: 6 givenname: Avery E. surname: Brown fullname: Brown, Avery E. – sequence: 7 givenname: Katherine E. surname: Pierce fullname: Pierce, Katherine E. – sequence: 8 givenname: David H. orcidid: 0000-0002-8077-4270 surname: Ge fullname: Ge, David H. – sequence: 9 givenname: Dennis surname: Vasquez-Montes fullname: Vasquez-Montes, Dennis – sequence: 10 givenname: Virginie surname: Lafage fullname: Lafage, Virginie – sequence: 11 givenname: Renaud orcidid: 0000-0002-4820-1835 surname: Lafage fullname: Lafage, Renaud – sequence: 12 givenname: Charla R. surname: Fischer fullname: Fischer, Charla R. – sequence: 13 givenname: Michael C. surname: Gerling fullname: Gerling, Michael C. – sequence: 14 givenname: Themistocles S. surname: Protopsaltis fullname: Protopsaltis, Themistocles S. – sequence: 15 givenname: Aaron J. surname: Buckland fullname: Buckland, Aaron J. – sequence: 16 givenname: Daniel M. surname: Sciubba fullname: Sciubba, Daniel M. – sequence: 17 givenname: Rafael surname: De La Garza-Ramos fullname: De La Garza-Ramos, Rafael – sequence: 18 givenname: Peter G. orcidid: 0000-0003-2635-2226 surname: Passias fullname: Passias, Peter G. email: peter.passias@nyumc.org |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32677572$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1177_21925682231212966 crossref_primary_10_1097_BSD_0000000000001244 crossref_primary_10_1097_BSD_0000000000001540 crossref_primary_10_21182_jmisst_2021_00360 crossref_primary_10_3171_2022_1_SPINE211496 |
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Keywords | retrospective studies comorbidity postoperative complications length of stay operative time minimally invasive surgical procedures patient readmission lumbosacral region |
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Snippet | Study Design:
Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution.
Objective:
To... Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. To assess differences in... Study Design: Retrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. Objective: To... STUDY DESIGNRetrospective cohort study of prospective patients undergoing minimally invasive lumbar fusion at a single academic institution. OBJECTIVETo assess... |
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StartPage | 619 |
SubjectTerms | Back surgery Comorbidity Intensive care Original Surgical outcomes Surgical techniques |
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Title | Complication Risk in Primary and Revision Minimally Invasive Lumbar Interbody Fusion: A Comparable Alternative to Conventional Open Techniques? |
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