Background Adult spinal deformity (ASD) is a deformity in the curvature of the adult spine. ASD includes a range of pathology that leads to decreased quality of life for patients as well as debilitating morbidities. Treatment can range from nonoperative management to long-segment surgical corrections and depends greatly on the deformity and patient profiles. If surgical treatment is indicated, circumferential (a combined anterior and posterior approach) fusion is one of the tools in the spine surgeon’s armamentarium. Depending on the complexity, the procedure is either completed on the same day or staged. Determining whether to perform a circumferential surgery in a staged fashion is based largely on the surgeon’s preference and perception of the individual case complexity; at present, there is no high-quality evidence that can be used to support that decision. Objective This paper presents the protocol for a systematic review that aims to investigate the differences between same-day versus staged circumferential fusion surgery in ASD both in patient selection and in outcomes. Methods Searches will be performed on MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. Gray literature and the reference lists of articles included in the full-text screening will also be screened for inclusion. Results will be exported to Covidence. Data will be collected on demographics, type of procedures performed, surgery levels, blood loss, total operation time, length of stay, disposition, readmissions (30 days and 90 days), and perioperative complications. Patient-reported outcomes will also be assessed. Data quality assessment of randomized controlled trials will be performed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials, and nonrandomized studies will be assessed with the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool. All screening, quality assessment, and data extraction will be done by 2 independent reviewers. A descriptive synthesis will be performed, and data will be evaluated for further analysis. Results This study is currently in the screening phase. There are no results yet. The search strategy has been developed and documented. Information has been exported to Covidence. Upon conclusion of the critical appraisal stage, screening and extraction, as well as a synthesis of the results, will be performed. Conclusions The intended review will summarize the differences in perioperative outcomes and complications between same-day and staged (circumferential) fusion surgery in adult spinal deformity. It will also describe the patients selected for such procedures based on their demographics and pathology. Identified gaps in knowledge will provide insight into current limitations and guide further studies on this topic. Trial Registration PROSPERO CRD42022339764; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=339764 International Registered Report Identifier (IRRID) PRR1-10.2196/42331
Differences between same-day and staged (circumferential) fusion surgery in adult spinal deformity.
BACKGROUND Adult spinal deformity (ASD) is a deformity in the curvature of the adult spine. Possible treatments of ASD include conservative and surgical management. If surgical treatment is indicated, (circumferential) fusion surgery is one of the procedures that may be performed. Depending on the complexity, the procedure is either done on the same day (SD) or staged (STA). OBJECTIVE This is a protocol of a systematic review that aims to investigate the differences between SD and STA (circumferential) fusion surgery in ASD. METHODS Searches have been performed on MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL). Results have been exported to Covidence. All screening, quality assessment, and data extraction will be done by two independent reviewers. A descriptive synthesis will be performed and data will be evaluated for further analysis. RESULTS This study is currently in the screening phase. There are no results yet. Search strategy has been developed and initiated. Information has been exported to Covidence. After conclusion of the critical appraisal stage, screening and extraction, synthesis of results will be performed. CONCLUSIONS The intended review will summarize the differences in perioperative outcomes and complications between same-day and staged (circumferential) fusion surgery in adult spinal deformity. Identified gaps in knowledge will provide insight into current limitations and guide further studies on this topic. CLINICALTRIAL PROSPERO CRD42022339764
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