After 9 Years of 3-Column Osteotomies, Are We Doing Better? Performance Curve Analysis of 573 Surgeries With 2-Year Follow-up.
| dc.contributor.author | Diebo, Bassel G | |
| dc.contributor.author | Lafage, Virginie | |
| dc.contributor.author | Varghese, Jeffrey J | |
| dc.contributor.author | Gupta, Munish | |
| dc.contributor.author | Kim, Han Jo | |
| dc.contributor.author | Ames, Christopher | |
| dc.contributor.author | Kebaish, Khaled | |
| dc.contributor.author | Shaffrey, Christopher | |
| dc.contributor.author | Hostin, Richard | |
| dc.contributor.author | Obeid, Ibrahim | |
| dc.contributor.author | Burton, Doug | |
| dc.contributor.author | Hart, Robert A | |
| dc.contributor.author | Lafage, Renaud | |
| dc.contributor.author | Schwab, Frank J | |
| dc.contributor.author | International Spine Study Group (ISSG) of Denver, Colorado | |
| dc.date.accessioned | 2023-07-08T12:34:26Z | |
| dc.date.available | 2023-07-08T12:34:26Z | |
| dc.date.issued | 2018-07 | |
| dc.date.updated | 2023-07-08T12:34:25Z | |
| dc.description.abstract | BackgroundIn spinal deformity treatment, the increased utilization of 3-column (3CO) osteotomies reflects greater comfort and better training among surgeons. This study aims to evaluate the longitudinal performance and adverse events (complications or revisions) for a multicenter group following a decade of 3CO.ObjectiveTo investigate if performance of 3CO surgeries improves with years of practice.MethodsPatients who underwent 3CO for spinal deformity with intra/postoperative and revision data collected up to 2 yr were included. Patients were chronologically divided into 4 even groups. Demographics, baseline deformity/correction, and surgical metrics were compared using Student t-test. Postoperative and revision rates were compared using Chi-square analysis.ResultsFive hundred seventy-three patients were stratified into: G1 (n = 143, 2004-2008), G2 (n = 142, 2008-2009), G3 (n = 144, 2009-2010), G4 (n = 144 2010-2013). The most recent patients were more disabled by Oswestry disability index (G4 = 49.2 vs G1 = 38.3, P = .001), and received a larger osteotomy resection (G4 = 26° vs G1 = 20°, P = .011) than the earliest group. There was a decrease in revision rate (45%, 35%, 33%, 30%, P = .039), notably in revisions for pseudarthrosis (16.7% G1 vs 6.9% G4, P = .007). Major complication rates also decreased (57%, 50%, 46%, 39%, P = .023) as did excessive blood loss (>4 L, 27.2 vs 16.7%, P = .023) and bladder/bowel deficit (4.2% vs 0.7% P = .002). Successful outcomes (no complications or revision) significantly increased (P = .001).ConclusionOver 9 yr, 3COs are being performed on an increasingly disabled population while gaining a greater correction at the osteotomy site. Revisions and complication rate decreased while success rate improved during the 2-yr follow-up period. | |
| dc.identifier | 3988109 | |
| dc.identifier.issn | 0148-396X | |
| dc.identifier.issn | 1524-4040 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
| dc.relation.ispartof | Neurosurgery | |
| dc.relation.isversionof | 10.1093/neuros/nyx338 | |
| dc.subject | International Spine Study Group (ISSG) of Denver, Colorado | |
| dc.subject | Humans | |
| dc.subject | Spinal Diseases | |
| dc.subject | Postoperative Complications | |
| dc.subject | Treatment Outcome | |
| dc.subject | Osteotomy | |
| dc.subject | Retrospective Studies | |
| dc.subject | Adult | |
| dc.subject | Aged | |
| dc.subject | Middle Aged | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.title | After 9 Years of 3-Column Osteotomies, Are We Doing Better? Performance Curve Analysis of 573 Surgeries With 2-Year Follow-up. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Shaffrey, Christopher|0000-0001-9760-8386 | |
| pubs.begin-page | 69 | |
| pubs.end-page | 75 | |
| pubs.issue | 1 | |
| 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 | 83 |
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