Prevalence and Prognosis of Coronal Malalignment Following Lateral Lumbar Interbody Fusion for Minimally Invasive Treatment of Adult Spinal Deformity.
dc.contributor.author | Chan, Andrew K | |
dc.contributor.author | Sampath, Shailen G | |
dc.contributor.author | Mummaneni, Praveen V | |
dc.contributor.author | Park, Paul | |
dc.contributor.author | Uribe, Juan S | |
dc.contributor.author | Turner, Jay D | |
dc.contributor.author | Le, Vivian P | |
dc.contributor.author | Eastlack, Robert K | |
dc.contributor.author | Fessler, Richard G | |
dc.contributor.author | Than, Khoi D | |
dc.contributor.author | Fu, Kai-Ming | |
dc.contributor.author | Wang, Michael Y | |
dc.contributor.author | Kanter, Adam S | |
dc.contributor.author | Okonkwo, David O | |
dc.contributor.author | Nunley, Pierce D | |
dc.contributor.author | Anand, Neel | |
dc.contributor.author | Mundis, Gregory M | |
dc.contributor.author | Passias, Peter G | |
dc.contributor.author | Bess, Shay | |
dc.contributor.author | Shaffrey, Christopher I | |
dc.contributor.author | Chou, Dean | |
dc.contributor.author | International Spine Study Group | |
dc.date.accessioned | 2024-12-06T21:22:50Z | |
dc.date.available | 2024-12-06T21:22:50Z | |
dc.date.issued | 2024-11 | |
dc.description.abstract | Study designRetrospective analysis of prospective multicenter adult spinal deformity (ASD) database.ObjectiveTo determine the prevalence and prognosis of postoperative coronal malalignment following LLIF for ASD with Qiu type A coronal alignment.Summary of background dataQiu Type A coronal alignment is defined as coronal vertical axis (CVA) <30mm.1 There is concern that circumferential minimally invasive surgery (cMIS) with lateral lumbar interbody fusion (LLIF) is associated with postoperative coronal malalignment in ASD with preoperative Qiu type A patients.MethodsQui type A patients undergoing cMIS with LLIF for ASD were included, with ASD defined with at least: maximum CC≥20°, SVA>5 cm, PI-LL≥10°, or PT>20°. Two year (2Y) clinical outcomes were compared for type A with 2Y CVA≥30 mm (MAL) versus <30 mm (ALIGN) and were adjusted for factors reaching P<0.05 on univariate comparisons (age, BMI, and ODI).Results43 patients met inclusion criteria, of which 12 (27.9%) developed coronal malalignment and 31 (72.1%) remained coronally aligned at 2Y. At baseline, MAL were older (73.0 vs. 69.0, P=0.045), had a lower BMI (26.09 vs. 29.45, P=0.047), and were less disabled (ODI 42.83 vs. 51.69, P=0.016). Otherwise, the groups were well-matched for baseline characteristics. At 2Y, MAL had a greater 2Y SVA (mean 54.08 vs 19.00 mm, P=0.01). Clinically, MAL was associated with inferior 2Y SF-36 PCS (34.78 vs. 37.42, adj P=0.043) and 2Y SRS-22r function/activity domain (3.03 vs. 3.36, adj P=0.040), but otherwise similar in other patient-reported-outcome-metrics (adj P>0.05 for all). 2Y complications were similar between groups, including for reoperations and major and minor complications (adj P>0.05 for all).ConclusionsIn Qui type A patients undergoing cMIS with LLIF for ASD, 27.9% develop coronal malalignment, which was associated with worse SF-36 PCS and SRS-22r function/activity. Despite radiographic malalignment, malalignment was not associated with higher 2-year complication rates including reoperations. | |
dc.identifier | 00007632-990000000-00838 | |
dc.identifier.issn | 0362-2436 | |
dc.identifier.issn | 1528-1159 | |
dc.identifier.uri | ||
dc.language | eng | |
dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
dc.relation.ispartof | Spine | |
dc.relation.isversionof | 10.1097/brs.0000000000005191 | |
dc.rights.uri | ||
dc.subject | International Spine Study Group | |
dc.title | Prevalence and Prognosis of Coronal Malalignment Following Lateral Lumbar Interbody Fusion for Minimally Invasive Treatment of Adult Spinal Deformity. | |
dc.type | Journal article | |
duke.contributor.orcid | Passias, Peter G|0000-0002-1479-4070|0000-0003-2635-2226 | |
duke.contributor.orcid | Shaffrey, Christopher I|0000-0001-9760-8386 | |
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 |
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