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
| dc.contributor.author | Yao, YC | |
| dc.contributor.author | Kim, HJ | |
| dc.contributor.author | Bannwarth, M | |
| dc.contributor.author | Smith, J | |
| dc.contributor.author | Bess, S | |
| dc.contributor.author | Klineberg, E | |
| dc.contributor.author | Ames, CP | |
| dc.contributor.author | Shaffrey, CI | |
| dc.contributor.author | Burton, D | |
| dc.contributor.author | Gupta, M | |
| dc.contributor.author | Mundis, GM | |
| dc.contributor.author | Hostin, R | |
| dc.contributor.author | Schwab, F | |
| dc.contributor.author | Lafage, V | |
| dc.date.accessioned | 2023-06-13T22:56:13Z | |
| dc.date.available | 2023-06-13T22:56:13Z | |
| dc.date.issued | 2023-05-01 | |
| dc.date.updated | 2023-06-13T22:56:13Z | |
| dc.description.abstract | Study Design: Retrospective cohort study. Objective: To 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. Methods: A 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. Results: Overall, 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. Conclusions: Fusion 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. | |
| dc.identifier.issn | 2192-5682 | |
| dc.identifier.issn | 2192-5690 | |
| dc.identifier.uri | ||
| dc.language | en | |
| dc.publisher | SAGE Publications | |
| dc.relation.ispartof | Global Spine Journal | |
| dc.relation.isversionof | 10.1177/21925682211009178 | |
| dc.title | 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 | |
| dc.type | Journal article | |
| duke.contributor.orcid | Shaffrey, CI|0000-0001-9760-8386 | |
| pubs.begin-page | 932 | |
| pubs.end-page | 939 | |
| pubs.issue | 4 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Orthopaedic Surgery | |
| pubs.organisational-group | Neurosurgery | |
| pubs.publication-status | Published | |
| pubs.volume | 13 |
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