PMID- 32291591 OWN - NLM STAT- MEDLINE DCOM- 20201228 LR - 20201228 IS - 0942-0940 (Electronic) IS - 0001-6268 (Linking) VI - 162 IP - 6 DP - 2020 Jun TI - Intermediate-term clinical and radiographic outcomes with less invasive adult spinal deformity surgery: patients with a minimum follow-up of 4 years. PG - 1393-1400 LID - 10.1007/s00701-020-04320-x [doi] AB - BACKGROUND: Little information exists regarding longer-term outcomes with minimally invasive spine surgery (MISS), particularly regarding long-segment and deformity procedures. We aimed to evaluate intermediate-term outcomes of MISS for adult spinal deformity (ASD). METHODS: This retrospective review of a prospectively collected multicenter database examined outcomes at 4 or more years following circumferential MIS (cMIS) or hybrid (HYB) surgery for ASD. A total of 53 patients at 8 academic centers satisfied the following inclusion criteria: age > 18 years and coronal Cobb > 20 degrees , pelvic incidence-lumbar lordosis (PI-LL) > 10 degrees , or sagittal vertical axis (SVA) > 5 cm. RESULTS: Radiographic outcomes demonstrated improvements of PI-LL from 16.8 degrees preoperatively to 10.8 degrees and coronal Cobb angle from 38 degrees preoperatively to 18.2 degrees at 4 years. The incidence of complications over the follow-up period was 56.6%. A total of 21 (39.6%) patients underwent reoperation in the thoracolumbar spine, most commonly for adjacent level disease or proximal junctional kyphosis, which occurred in 11 (20.8%) patients. Mean Oswestry Disability Index (ODI) at baseline and years 1 through 4 were 49.9, 33.1, 30.2, 32.7, and 35.0, respectively. The percentage of patients meeting minimal clinically important difference (MCID) (defined as 12% or more from baseline) decreased over time, with leg pain reduction more durable than back pain reduction. CONCLUSIONS: Intermediate-term clinical and radiographic improvement following MISS for ASD is sustained, but extent of improvement lessens over time. Outcome variability exists within a subset of patients not meeting MCID, which increases over time after year two. Loss of improvement over time was more notable in back than leg pain. However, average ODI improvement meets MCID at 4 years after MIS ASD surgery. FAU - Wang, Michael Y AU - Wang MY AD - Department of Neurological Surgery, Lois Pope Life Center, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, USA. MWang2@med.miami.edu. FAU - Park, Paul AU - Park P AD - Department of Neurological Surgery, University of Michigan, Ann Arbor, MI, USA. FAU - Tran, Stacie AU - Tran S AD - Department of Orthopedic Surgery, San Diego Center for Spinal Disorders, La Jolla, CA, USA. FAU - Anand, Neel AU - Anand N AD - Department of Orthopedic Surgery, Cedars Sinai Hospital, Los Angeles, CA, USA. FAU - Nunley, Pierce AU - Nunley P AD - Department of Orthopedic Surgery, Spine Institute of Louisiana, Shreveport, LA, USA. FAU - Kanter, Adam AU - Kanter A AD - Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. FAU - Fessler, Richard AU - Fessler R AD - Department of Neurosurgery, Rush University, Chicago, IL, USA. FAU - Uribe, Juan AU - Uribe J AD - Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA. FAU - Eastlack, Robert AU - Eastlack R AD - Department of Neurological Surgery, Scripps Clinic Torrey Pines, La Jolla, CA, USA. FAU - Shaffrey, Christopher I AU - Shaffrey CI AD - Department of Neurological Surgery, Duke University, Durham, NC, USA. FAU - Bess, Shay AU - Bess S AD - Department of Orthopedic Surgery, Denver International Spine Center, Denver, CO, USA. FAU - Mundis, Gregory M Jr AU - Mundis GM Jr AD - Department of Orthopedic Surgery, Scripps Clinic Torrey Pines, La Jolla, CA, USA. FAU - Brusko, G Damian AU - Brusko GD AD - Department of Neurological Surgery, Lois Pope Life Center, University of Miami Miller School of Medicine, 1095 NW 14th Terrace, Miami, FL, USA. FAU - Mummaneni, Praveen V AU - Mummaneni PV AD - Department of Neurological Surgery, University of California, San Francisco, CA, USA. CN - MIS-ISSG Group LA - eng PT - Journal Article PT - Multicenter Study DEP - 20200414 PL - Austria TA - Acta Neurochir (Wien) JT - Acta neurochirurgica JID - 0151000 SB - IM CIN - Acta Neurochir (Wien). 2020 Jun;162(6):1389-1391. PMID: 32300987 MH - Adult MH - Aged MH - Female MH - Humans MH - Kyphosis/*surgery MH - Lordosis/*surgery MH - Male MH - Middle Aged MH - Minimally Invasive Surgical Procedures/adverse effects/*methods MH - Neurosurgical Procedures/adverse effects/*methods MH - Postoperative Complications/*epidemiology MH - Reoperation/statistics & numerical data MH - Spine/diagnostic imaging/surgery OTO - NOTNLM OT - Long-term follow-up OT - Minimally invasive OT - Patient reported outcomes measures (PROMs) OT - Spinal deformity EDAT- 2020/04/16 06:00 MHDA- 2020/12/29 06:00 CRDT- 2020/04/16 06:00 PHST- 2019/12/20 00:00 [received] PHST- 2020/04/02 00:00 [accepted] PHST- 2020/04/16 06:00 [pubmed] PHST- 2020/12/29 06:00 [medline] PHST- 2020/04/16 06:00 [entrez] AID - 10.1007/s00701-020-04320-x [pii] AID - 10.1007/s00701-020-04320-x [doi] PST - ppublish SO - Acta Neurochir (Wien). 2020 Jun;162(6):1393-1400. doi: 10.1007/s00701-020-04320-x. Epub 2020 Apr 14.