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

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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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Acknowledgements

We thank Dr. Guy Harris DO of DMC Corp. (www.dmed.co.jp) for his support with the writing of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Soichiro Masuda, Shunsuke Fujibayashi, Bungo Otsuki, Koichi Murata, Takayoshi Shimizu & Shuichi Matsuda

  2. Department of Orthopaedic Surgery, Kyoto City Hospital, Kyoto, Japan

    Mitsuru Takemoto

  3. Department of Orthopaedic Surgery, Kitano Hospital, Osaka, Japan

    Masato Ota

  4. Department of Orthopaedic Surgery, Kobe Central General Hospital, Kobe, Japan

    Eijiro Onishi

  5. Department of Orthopaedic Surgery, Gakkentoshi Hospital, Kyoto, Japan

    Seiichi Odate

  6. Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan

    Ryosuke Tsutumi

  7. Department of Orthopaedic Surgery, Kansai Electric Power Hospital, Osaka, Japan

    Masanori Izeki

  8. Department of Orthopaedic Surgery, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan

    Hiroaki Kimura

  9. Department of Orthopaedic Surgery, Shiga General Hospital, Shiga, Japan

    Shimei Tanida

Authors
  1. Soichiro Masuda
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  2. Shunsuke Fujibayashi
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  7. Ryosuke Tsutumi
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  8. Masanori Izeki
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  9. Hiroaki Kimura
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  11. Bungo Otsuki
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  12. Koichi Murata
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  13. Takayoshi Shimizu
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  14. Shuichi Matsuda
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Correspondence to Soichiro Masuda.

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Masuda, S., Fujibayashi, S., Takemoto, M. et al. Association of two-staged surgery with systemic perioperative complications in lateral lumbar interbody fusion for adult spinal deformity: a propensity score-weighted study. Eur Spine J 32, 950–956 (2023). https://doi.org/10.1007/s00586-023-07539-1

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  • DOI: https://doi.org/10.1007/s00586-023-07539-1

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