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Planned two-stage surgery using lateral lumbar interbody fusion and posterior corrective fusion: a retrospective study of perioperative complications

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Abstract

Purpose

To determine the effect of planned two-stage surgery using lateral lumbar interbody fusion (LLIF) on the perioperative complication rate following corrective fusion surgery in patients with kyphoscoliosis.

Methods

Consecutive patients with degenerative scoliosis who underwent corrective fusion were divided into a control group that underwent single-stage posterior-only surgery and a group that underwent planned two-staged surgery with LLIF and posterior corrective fusion. We collected the patient background and surgical data and assessed the perioperative complication rates. We also investigated spinopelvic parameters and patient-reported outcome measurements (PROMs).

Results

One hundred and thirty-eight patients of mean age 69.8 (range, 50–84) years who met the study inclusion criteria were included. The two-stage group (n = 75) underwent a staged anterior–posterior surgical procedure, and the control group (n = 63) underwent single-stage surgery. There was no significant between-group difference in the incidence of perioperative complications, except for deep wound infection (reoperation is necessary for surgical site infection). Revision surgery within 3 months of the initial surgery was more common in the control group (n = 8, 12.7%) than in the two-stage group (n = 3, 4.0%). Spinopelvic parameters and PROMs were significantly better in the two-stage group at 2 years postoperatively.

Conclusion

The complication rate for planned two-stage surgery was similar to that of previous posterior-only single-stage surgery. However, early reoperation was less common, and the degree of spinal correction and clinical results were significantly better after two-stage surgery.

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Data availability

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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Acknowledgements

The authors would like to express their sincere gratitude to Ms. Nao Kuwahara, Tomoe Mabuchi and Mrs. Taku Nagao and Tomokazu Suzuki, secretaries in the Department of Orthopedic Surgery, for their excellent contribution in data collection. The authors also would like to thank Editage (www.editage.com) for English language editing.

Funding

Medtronic Sofamor Danek Inc., Japan Medical Dynamic Marketing Inc., and Meitoku Medical Institution Jyuzen Memorial Hospital.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-ku, Hamamatsu City, Shizuoka, 431-3192, Japan

    Yu Yamato, Tomohiko Hasegawa, Go Yoshida, Tomohiro Banno, Shin Oe, Hideyuki Arima, Yuki Mihara, Hiroki Ushirozako, Tomohiro Yamada, Koichiro Ide, Yuh Watanabe & Yukihiro Matsuyama

  2. Division of Geriatric Musculoskeletal Health, Hamamatsu University School of Medicine, Hamamatsu City, Shizuoka, Japan

    Yu Yamato & Shin Oe

  3. Department of Orthopaedic Surgery, Iwata City Hospital, Iwata City, Shizuoka, Japan

    Tatsuya Yasuda

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  1. Yu Yamato
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  2. Tomohiko Hasegawa
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Corresponding author

Correspondence to Yu Yamato.

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Conflicts of interest

Yu Yamato and Shin Oe work at a donation-endowed laboratory and are funded by Medtronic Sofamor Danek Inc., Japan Medical Dynamic Marketing Inc., and Meitoku Medical Institution Jyuzen Memorial Hospital. For the remaining authors, none were declared. The manuscript submitted does not contain information about medical device(s)/drug(s).

Consent to participate

The need for informed consent was waived because of the retrospective study design.

Ethics approval

The study was approved by our hospital’s institutional review board (approval number 19–343).

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Yamato, Y., Hasegawa, T., Yoshida, G. et al. Planned two-stage surgery using lateral lumbar interbody fusion and posterior corrective fusion: a retrospective study of perioperative complications. Eur Spine J 30, 2368–2376 (2021). https://doi.org/10.1007/s00586-021-06879-0

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  • DOI: https://doi.org/10.1007/s00586-021-06879-0

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