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Staged Versus Same-Day Surgery in Circumferential Minimally Invasive Deformity Correction.
John Paul G Kolcun1, Richard G Fessler1, Pierce D Nunley2
1Department of Neurological Surgery, Rush University Medical Center, Chicago , Illinois , USA.
Neurosurgery
|May 24, 2024
Summary
Staged or same-day minimally invasive surgery for adult spinal deformity yields similar 2-year outcomes. Staged surgery may suit patients with greater deformity or frailty needing extensive procedures.
Area of Science:
- Spine surgery
- Orthopedics
- Minimally invasive surgery
Background:
- Adult spinal deformity (ASD) presents complex treatment challenges.
- Circumferential minimally invasive surgery (cMIS) offers a less invasive approach to ASD correction.
- The optimal surgical timing (staged vs. same-day) for cMIS in ASD remains under investigation.
Purpose of the Study:
- To compare long-term clinical and radiographic outcomes between staged and same-day cMIS for adult spinal deformity.
- To evaluate the impact of surgical approach on patient recovery and deformity correction.
Main Methods:
- A prospective, multi-institution database was utilized to identify patients undergoing cMIS for ASD.
- Preoperative and 2-year postoperative clinical and radiographic parameters were compared between staged and same-day cohorts.
- Eighty-five patients (27 staged, 58 same-day) with 2-year follow-up were analyzed.
Main Results:
- Staged cMIS involved more extensive surgeries and longer hospital stays compared to same-day procedures (P < .001).
- No significant differences in preoperative or 2-year postoperative clinical outcomes were observed between the two groups.
- Patients in the staged cohort had greater preoperative coronal deformity, achieving a more significant reduction at 2 years (P < .01).
Conclusions:
- Both staged and same-day cMIS approaches demonstrate comparable clinical and radiographic outcomes at 2 years postoperatively for adult spinal deformity.
- Staged cMIS may be a more suitable option for patients with severe deformity, higher frailty, or those requiring prolonged and complex surgical interventions.
