PMID- 33464551
OWN - NLM
STAT- MEDLINE
DCOM- 20211118
LR  - 20211118
IS  - 2212-1358 (Electronic)
IS  - 2212-134X (Linking)
VI  - 9
IP  - 4
DP  - 2021 Jul
TI  - How is staging of ALIF following posterior spinal arthrodesis to the pelvis 
      related to functional improvement in patients with adult spinal deformity?
PG  - 1085-1091
LID - 10.1007/s43390-020-00272-5 [doi]
AB  - STUDY DESIGN: Retrospective cohort. OBJECTIVES: To compare postoperative 
      functional improvement in patients who underwent staged versus non-staged 
      anterior-posterior spinal arthrodesis for adult spinal deformity (ASD). In 
      patients with ASD, spinal arthrodesis can be performed in 2 stages to avoid the 
      physiologic insult of a lengthy surgery. The association between staged surgery 
      and postoperative functional improvement has not been well studied. METHODS: We 
      included 87 patients (59 women) with ASD who underwent anterior-posterior spinal 
      arthrodesis of > 5 levels with fixation to the pelvis from 2010-2014. Primary 
      outcomes were the frequency of achieving at least a minimal clinically important 
      difference (MCID) in the Scoliosis Research Society-22r (SRS-22r) Activity domain 
      and the timeframe in which it was achieved. The secondary outcome was patient 
      satisfaction (SRS-22r Patient Satisfaction domain). A Cox proportional hazard 
      model was used to compare functional improvement over time between staged and 
      non-staged groups. Our study was powered to detect a relative hazard ratio of 
      0.53, beta = 0.20. alpha = 0.05. RESULTS: The frequency of achieving an MCID in SRS-22r 
      Activity score did not differ significantly between the staged group (33/41 
      patients) and the non-staged group (34/46 patients) (hazard ratio 0.74; 95% 
      confidence interval 0.41-1.36). Median times to achieving an MCID in SRS-22r 
      Activity score were 191 days (interquartile range: 86-674) in the staged group 
      and 181 days (interquartile range: 72-474) in the non-staged group (p = .75). The 
      staged and non-staged groups had similar SRS-22r Patient Satisfaction scores at 
      3-9 months postoperatively and at final follow-up (both, p > .05). CONCLUSION: 
      Patients with ASD who underwent staged anterior-posterior spinal arthrodesis 
      within 3 months after index surgery were similarly likely to experience 
      functional improvement in the same timeframe as patients who underwent non-staged 
      surgery. Patient satisfaction did not differ significantly between staged and 
      non-staged groups. LEVEL OF EVIDENCE: III.
CI  - (c) 2021. Scoliosis Research Society.
FAU - Harris, Andrew B
AU  - Harris AB
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Puvanesarajah, Varun
AU  - Puvanesarajah V
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Raad, Micheal
AU  - Raad M
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Marrache, Majd
AU  - Marrache M
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Ren, Mark
AU  - Ren M
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Skolasky, Richard L
AU  - Skolasky RL
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Kebaish, Khaled M
AU  - Kebaish KM
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA.
FAU - Neuman, Brian J
AU  - Neuman BJ
AD  - Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N. Caroline 
      Street, JHOC 5241, Baltimore, MD, 21287, USA. bneuman7@jhmi.edu.
LA  - eng
PT  - Journal Article
DEP - 20210119
PL  - England
TA  - Spine Deform
JT  - Spine deformity
JID - 101603979
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Pelvis
MH  - Quality of Life
MH  - Retrospective Studies
MH  - *Scoliosis/surgery
MH  - *Spinal Fusion
OTO - NOTNLM
OT  - Adult spinal deformity
OT  - Functional improvement
OT  - Quality of life
OT  - Satisfaction
OT  - Scoliosis
OT  - Staged spinal arthrodesis.
EDAT- 2021/01/20 06:00
MHDA- 2021/11/19 06:00
CRDT- 2021/01/19 12:17
PHST- 2020/04/14 00:00 [received]
PHST- 2020/12/14 00:00 [accepted]
PHST- 2021/01/20 06:00 [pubmed]
PHST- 2021/11/19 06:00 [medline]
PHST- 2021/01/19 12:17 [entrez]
AID - 10.1007/s43390-020-00272-5 [pii]
AID - 10.1007/s43390-020-00272-5 [doi]
PST - ppublish
SO  - Spine Deform. 2021 Jul;9(4):1085-1091. doi: 10.1007/s43390-020-00272-5. Epub 2021 
      Jan 19.