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Lowest Instrumented Vertebra Selection to S1 or Ilium Versus L4 or L5 in Adult Spinal Deformity: Factors for Consideration in 349 Patients With a Mean 46-Month Follow-Up.
- Source :
- Global spine journal; vol 13, iss 4, 932-939; 2192-5682
- Publication Year :
- 2023
-
Abstract
- Study designRetrospective cohort study.ObjectiveTo compare the outcomes of patients with adult spinal deformity (ASD) following spinal fusion with the lowest instrumented vertebra (LIV) at L4/L5 versus S1/ilium.MethodsA multicenter ASD database was evaluated. Patients were categorized into 2 groups based on LIV levels-groups L (fusion to L4/L5) and S (fusion to S1/ilium). Both groups were propensity matched by age and preoperative radiographic alignments. Patient demographics, operative details, radiographic parameters, revision rates, and health-related quality of life (HRQOL) scores were compared.ResultsOverall, 349 patients had complete data, with a mean follow-up of 46 months. Patients in group S (n = 311) were older and had larger sagittal and coronal plane deformities than those in group L (n = 38). After matching, 28 patients were allocated to each group with similar demographic, radiographic, and clinical parameters. Sagittal alignment restoration at postoperative week 6 was significantly better in group S than in group L, but it was similar in both groups at the 2-year follow-up. Fusion to S1/ilium involved a longer operating time, higher PJK rates, and greater PJK angles than that to L4/L5. There were no significant differences in the complication and revision rates between the groups. Both groups showed significant improvements in HRQOL scores.ConclusionsFusion to S1/ilium had better sagittal alignment restoration at postoperative week 6 and involved higher PJK rates and greater PJK angles than that to L4/L5. The clinical outcomes and rates of revision surgery and complications were similar between the groups.
Details
- Database :
- OAIster
- Journal :
- Global spine journal; vol 13, iss 4, 932-939; 2192-5682
- Notes :
- Yao, Yu-Cheng, Kim, Han Jo, Bannwarth, Mathieu, Smith, Justin, Bess, Shay, Klineberg, Eric, Ames, Christopher P, Shaffrey, Christopher I, Burton, Douglas, Gupta, Munish, Mundis, Gregory M, Hostin, Richard, Schwab, Frank, Lafage, Virginie
- Publication Type :
- Electronic Resource
- Accession number :
- edsoai.on1391594790
- Document Type :
- Electronic Resource