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Published in: European Spine Journal 3/2023

21-01-2023 | Original Article

Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study

Authors: Soichiro Masuda, Shunsuke Fujibayashi, Mitsuru Takemoto, Masato Ota, Eijiro Onishi, Seiichi Odate, Ryosuke Tsutumi, Masanori Izeki, Hiroaki Kimura, Shimei Tanida, Bungo Otsuki, Koichi Murata, Takayoshi Shimizu, Shuichi Matsuda

Published in: European Spine Journal | Issue 3/2023

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Abstract

Purpose

Adult spinal deformity (ASD) surgery carries a higher risk of perioperative systemic complications. However, evidence for the effect of planned two-staged surgery on the incidence of perioperative systemic complications is scarce. Here, we evaluated the effect of two-staged surgery on perioperative complications following ASD surgery using lateral lumbar interbody fusion (LLIF).

Methods

The study was conducted under a retrospective multi-center cohort design. Data on 293 consecutive ASD patients (107 in the two-staged group and 186 in the one-day group) receiving corrective surgery using LLIF between 2012 and 2021 were collected. Clinical outcomes included occurrence of perioperative systemic complications, reoperation, and intraoperative complications, operation time, intraoperative blood loss, transfusion, and length of hospital stay. The analysis was conducted using propensity score (PS)-stabilized inverse probability treatment weighting to adjust for confounding factors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated in a PS-weighted cohort.

Results

In this cohort, 19 (18.4%) patients in the two-staged group and 43 (23.1%) patients in the one-day group experienced any systemic perioperative complication within 30 days following ASD surgery. In the PS-weighted cohort, compared with the patients undergoing one-day surgery, no association with the risk of systemic perioperative complications was seen in patients undergoing two-staged surgery (PS-weighted OR 0.78, 95% CI 0.37–1.63; p = 0.51).

Conclusion

Our study suggested that two-staged surgery was not associated with risk for perioperative systemic complications following ASD surgery using LLIF.
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Metadata
Title
Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study
Authors
Soichiro Masuda
Shunsuke Fujibayashi
Mitsuru Takemoto
Masato Ota
Eijiro Onishi
Seiichi Odate
Ryosuke Tsutumi
Masanori Izeki
Hiroaki Kimura
Shimei Tanida
Bungo Otsuki
Koichi Murata
Takayoshi Shimizu
Shuichi Matsuda
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 3/2023
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-023-07539-1

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