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4. Similar Short-Term Outcomes of Adolescent Idiopathic Scoliosis Surgery with or without Drainage: A Systematic Review of the Literature and Meta-Analysis

Author

Ruffilli, Alberto, primary, Traversari, Matteo, additional, Viroli, Giovanni, additional, Manzetti, Marco, additional, Ialuna, Marco, additional, Morandi Guaitoli, Manuele, additional, Mazzotti, Antonio, additional, Artioli, Elena, additional, Zielli, Simone Ottavio, additional, Arceri, Alberto, additional, and Faldini, Cesare, additional

Published
2024
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5. Frailty Influence on Postoperative Surgical Site Infections After Surgery for Degenerative Spine Disease and Adult Spine Deformity. Can a Frailty Index be a Valuable Summary Risk Indicator? A Systematic Review and Metanalysis of the Current Literature

Author

Manzetti, Marco, primary, Ruffilli, Alberto, additional, Viroli, Giovanni, additional, Traversari, Matteo, additional, Ialuna, Marco, additional, Salamanna, Francesca, additional, Neri, Simona, additional, and Faldini, Cesare, additional

Published
2024
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14. Sarcopenia and osteopenia are independent risk factors for proximal junctional disease after posterior lumbar fusion: Results of a retrospective study

Author

Traversari, Matteo, primary, Ruffilli, Alberto, additional, Barile, Francesca, additional, Cerasoli, Tosca, additional, Manzetti, Marco, additional, Viroli, Giovanni, additional, Ialuna, Marco, additional, Salamanna, Francesca, additional, Mazzotti, Antonio, additional, Fini, Milena, additional, and Faldini, Cesare, additional

Published
2023
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18. Sarcopenia and osteopenia are independent risk factors for proximal junctional disease after posterior lumbar fusion: Results of a retrospective study.

Author

Ruffilli, Alberto, Barile, Francesca, Cerasoli, Tosca, Manzetti, Marco, Viroli, Giovanni, Ialuna, Marco, Traversari, Matteo, Salamanna, Francesca, Mazzotti, Antonio, Fini, Milena, and Faldini, Cesare

Subjects
SPINAL fusion, REOPERATION, SARCOPENIA, OSTEOPENIA, DISEASE risk factors, MAGNETIC resonance imaging, BODY mass index
Abstract

Study Design: This was a retrospective study. Objective: Since a better understanding of modifiable risk factors for proximal junctional disease (PJD) may lead to improved postoperative outcomes and less need of revision surgery, the aim of the present study is to determine whether sarcopenia and osteopenia are independent risk factors for PJD in patients undergoing lumbar fusion. Summary of Background Data: PJD is one of the most frequent complications following posterior instrumented spinal fusion. It is characterized by a spectrum of pathologies ranging from proximal junctional kyphosis (PJK) to proximal junctional failure (PJF). The etiology of PJD is multifactorial and currently not fully understood. Patient-specific factors, such as age, body mass index, osteoporosis, sarcopenia, and the presence of other comorbidities, can represent potential risk factors. Materials and Methods: A retrospective review of patients, aging 50–85 years, who underwent a short (≤3 levels) posterior lumbar fusion for degenerative diseases was performed. Through magnetic resonance imaging (MRI), central sarcopenia and osteopenia were evaluated, measuring the psoas-to-lumbar vertebral index (PLVI) and the M-score. A multivariate analysis was performed to determine the independent risk factors for PJD, PJK, and PJF. Results: A total of 308 patients (mean age at surgery 63.8 ± 6.2 years) were included. Ten patients (3.2%) developed a PJD and all required revision surgery. Multivariate regression identified PLVI (P = 0.02) and M-score (P = 0.04) as independent risk factors for both PJK (P = 0.02 and P = 0.04, respectively) and PJF (P = 0.04 and P = 0.01, respectively). Conclusions: Sarcopenia and osteopenia, as measured by PLVI and M-score, proved to be independent risk factors for PJD in patients who undergo lumbar fusion for degenerative diseases. Clinical Trial Registration: The present study was approved by the Institutional Review Board, CE AVEC 208/2022/OSS/IOR. [ABSTRACT FROM AUTHOR]

Published
2023
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19. Return to sport after posterior spinal fusion for adolescent idiopathic scoliosis: what variables actually have an influence? A retrospective study

Author

Alberto Ruffilli, Francesca Barile, Giovanni Viroli, Marco Manzetti, Matteo Traversari, Marco Ialuna, Bartlomiej Dobromir Bulzacki Bogucki, Cesare Faldini, Ruffilli, Alberto, Barile, Francesca, Viroli, Giovanni, Manzetti, Marco, Traversari, Matteo, Ialuna, Marco, Bulzacki Bogucki, Bartlomiej Dobromir, and Faldini, Cesare

Subjects
Posterior spinal fusion, Lumbar Vertebrae, Adolescent, Thoracic Vertebrae, Follow-Up Studie, Return to Sport, Spinal Fusion, Treatment Outcome, Scoliosis, Adolescent idiopathic scoliosi, Retrospective Studie, Humans, Orthopedics and Sports Medicine, Scoliosi, Kyphosis, Sport, Human, Retrospective Studies, Follow-Up Studies
Abstract

Purpose To retrospectively evaluate a cohort of athletically active patients who underwent surgery for adolescent idiopathic scoliosis (AIS), and to determine which clinical, surgical and anthropometric variables influenced their return to sport after surgery. Methods 112 adolescents who underwent high-density posterior fusion for AIS by a single surgeon were analyzed for clinical, surgical and demographic predictors of return to presurgical physical activity levels. Data were retrospectively collected by charts and X-rays analysis and patients interviews. Results Preoperative main curve Cobb was 64.4 ± 14.12° and obtained correction was 70.0 ± 12.5%. Included patients played many different sports (Table 4), most of all ballet (44/112, 39.2%), swimming (40/112, 35.7%) and gymnastics (32/112, 28.6%). At an average of 50.3 months follow-up, 76 (67.8%) patients returned to sports (RTS) at an equal or higher level than preoperatively. Younger age, lower Lenke curve type and lower main curve Cobb were significantly associated with RTS. As for RTS timing, patients who returned within the first 6 months were younger, with a higher Lenke and a less severe main curve, a more distal UIV and a more proximal LIV. No complications related to RTS were registered. Conclusion In conclusion, patients with adolescent idiopathic scoliosis safely returned to physical activity after surgery. Younger age, higher Lenke type and lower main curve severity predicted a quicker return to sport. However, prospective studies are needed to confirm these findings.

Published
2022
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20. One stage correction via the Hi-PoAD technique for the management of severe, stiff, adolescent idiopathic scoliosis curves > 90°

Author

Cesare Faldini, Giovanni Viroli, Francesca Barile, Marco Manzetti, Marco Ialuna, Matteo Traversari, Fabio Vita, Alberto Ruffilli, Faldini, Cesare, Viroli, Giovanni, Barile, Francesca, Manzetti, Marco, Ialuna, Marco, Traversari, Matteo, Vita, Fabio, and Ruffilli, Alberto

Subjects
Scoliosis, Orthopedics and Sports Medicine, Idiopathic adolescent scoliosi, Pedicle screw accuracy, Pre-operative CT, Pedicle screw malpositioning
Abstract

Study design Retrospective cohort study. Purpose to assess the efficacy and safety of Hi-PoAD technique in patients with a major thoracic curve > 90°, Methods retrospective review of AIS patients with a major thoracic curve (Lenke 1–2–3) > 90°, with Results 19 patients were enrolled. A 65.0% correction rate of the main curve was achieved, from 101.9° to 35.7° (p p = 0.013). Trunk Height increased from 31.1 to 37.0 cm (p p = 0.017). SRS-22 increased in all patients, from 2.1 to 3.9 at 1 year of follow-up (p 25; conversely, among patients who had a one-stage procedure, only 1 (6.2%) had a T-DAR > 25 (p = 0.008). Conclusions The Hi-PoAD technique proved to be a valid alternative for the treatment of severe, rigid AIS involving more than 5 vertebral bodies. Study design Retrospective comparative cohort study. Level of evidence III.

Published
2023
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21. Osteopenia and Sarcopenia as Potential Risk Factors for Surgical Site Infection after Posterior Lumbar Fusion: A Retrospective Study

Author

Alberto Ruffilli, Marco Manzetti, Tosca Cerasoli, Francesca Barile, Giovanni Viroli, Matteo Traversari, Francesca Salamanna, Milena Fini, Cesare Faldini, Ruffilli, Alberto, Manzetti, Marco, Cerasoli, Tosca, Barile, Francesca, Viroli, Giovanni, Traversari, Matteo, Salamanna, Francesca, Fini, Milena, and Faldini, Cesare

Subjects
sarcopenia, Microbiology (medical), osteopenia, risk factor, Virology, surgical site infection, lumbar spinal fusion, Microbiology, risk factors
Abstract

Surgical site infection (SSI) is a feared complication in spinal surgery, that leads to lower outcomes and increased healthcare costs. Among its risk factors, sarcopenia and osteopenia have recently attracted particular interest. The purpose of this article is to evaluate the influence of sarcopenia and osteopenia on the postoperative infection rate in patients treated with posterior fusion for degenerative diseases of the lumbar spine. This retrospective study included data from 308 patients. Charts were reviewed and central sarcopenia and osteopenia were evaluated through magnetic resonance images (MRI), measuring the psoas to lumbar vertebral index (PLVI) and the M score. Multivariate linear regression was performed to identify independent risk factors for infection. The postoperative SSI rate was 8.4%. Patients with low PLVI scores were not more likely to experience postoperative SSI (p = 0.68), while low M-score patients were at higher risk of developing SSI (p = 0.04). However, they did not generally show low PLVI values (p = 0.5) and were homogeneously distributed between low and high PLVI (p = 0.6). Multivariate analysis confirmed a low M score to be an independent risk factor for SSI (p = 0.01). Our results suggest that osteopenia could have significant impact on spinal surgery, and prospective studies are needed to better investigate its role.

Published
2022

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