Effect of Smoking Status on Successful Arthrodesis, Clinical Outcome, and Complications After Anterior Lumbar Interbody Fusion (ALIF)

Phan, Kevin; Fadhil, Matthew; Chang, Nicholas; Giang, Gloria; Gragnaniello, Cristian; Mobbs, Ralph J.

doi:10.1016/j.wneu.2017.11.157

Cited by 33 publications

(21 citation statements)

References 29 publications

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“…The selection of predictors was based on evidence of their predictive capacity in the current literature [18][19][20][21][22][23][24][25]28]. All the predictor variables are collected systematically in the registry and are typically known or decided upon preoperatively, on the "admission" section of the Spine Tango Form.…”

Section: Predictorsmentioning

confidence: 99%

“…In the present study our aim was to combine previously identified individual predictors of outcome, e.g. number of previous spine surgeries [18,19], age [20], ASA score [21], complexity of the surgery [22], BMI [23], and smoking status [24,25] in a multivariable model to predict complications, using a large multicentre dataset from the EUROSPINE "Spine Tango" registry [26]. We sought to develop two models and a web-based tool for predicting the likelihood of incurring a perioperative complication in connection with spine surgery: one focusing on general medical complications and the other, on surgical complications.…”

Section: Introductionmentioning

confidence: 99%

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Development of a model to predict the probability of incurring a complication during spine surgery

et al. 2021

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Purpose Predictive models in spine surgery are of use in shared decision-making. This study sought to develop multivariable models to predict the probability of general and surgical perioperative complications of spinal surgery for lumbar degenerative diseases. Methods Data came from EUROSPINE's Spine Tango Registry (1.2012–12.2017). Separate prediction models were built for surgical and general complications. Potential predictors included age, gender, previous spine surgery, additional pathology, BMI, smoking status, morbidity, prophylaxis, technology used, and the modified Mirza invasiveness index score. Complete case multiple logistic regression was used. Discrimination was assessed using area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CI). Plots were used to assess the calibration of the models. Results Overall, 23′714/68′111 patients (54.6%) were available for complete case analysis: 763 (3.2%) had a general complication, with ASA score being strongly predictive (ASA-2 OR 1.6, 95% CI 1.20–2.12; ASA-3 OR 2.98, 95% CI 2.19–4.07; ASA-4 OR 5.62, 95% CI 3.04–10.41), while 2534 (10.7%) had a surgical complication, with previous surgery at the same level being an important predictor (OR 1.9, 95%CI 1.71–2.12). Respectively, model AUCs were 0.74 (95% CI, 0.72–0.76) and 0.64 (95% CI, 0.62–0.65), and calibration was good up to predicted probabilities of 0.30 and 0.25, respectively. Conclusion We developed two models to predict complications associated with spinal surgery. Surgical complications were predicted with less discriminative ability than general complications. Reoperation at the same level was strongly predictive of surgical complications and a higher ASA score, of general complications. A web-based prediction tool was developed at https://sst.webauthor.com/go/fx/run.cfm?fx=SSTCalculator.

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Section: Predictorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a model to predict the probability of incurring a complication during spine surgery

et al. 2021

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“…In addition, smoking can reportedly affect bone fusion. 26 In a recent clinical study, Phan et al 27 found that after anterior lumbar interbody fusion, the fusion rate was significantly lower in smokers than in nonsmokers. Nicotine is the main ingredient in tobacco, and large doses of nicotine can inhibit the proliferation of osteoblasts and increase the expression of osteocalcin and type I collagen.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Biocage in treating single-segment lumbar degenerative disease in patients with high risk of non-fusion: a prospective controlled study with at least 2 years’ follow-up

Yang

Hou

et al. 2020

J Int Med Res

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Objective To evaluate the clinical efficacy of an allogeneic bone cage (Biocage; Beijing Datsing Bio-Tech Co., Ltd., Beijing, China) for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion. Methods From January 2013 to December 2016, 67 patients who underwent lumbar fusion were divided into the Biocage group (n = 33) and polyether ether ketone (PEEK) group (n = 34). The patients were followed up for 24 to 48 months. The mean intervertebral height of the fusion level, fusion rate, height of the intervertebral foramen, visual analog scale score, and Oswestry disability index were compared. Results The PEEK group had a lower fusion rate than the Biocage group (88.24% vs. 90.91%), although the difference was not statistically significant. During follow-up, the height of the intervertebral space was similar between the Biocage and PEEK groups (12.88 ± 0.45 and 12.84 ± 1.01 mm, respectively). The height of the intervertebral foramen was larger in the Biocage than PEEK group (20.67 ± 1.34 vs. 20.00 ± 2.05 mm). Good clinical efficacy was achieved in both groups. Conclusion The Biocage is efficient and safe for treatment of single-segment lumbar degenerative disease in patients with a high risk of non-fusion.

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“…Anterior approaches to the thoracic and lumbar spine provide better exposure of the ventral surface of vertebral discs, with the main advantage of avoiding manipulation of the paravertebral muscles and ligaments, and a consequent lesser postoperative pain and risk of mechanical instability, Fig. 3 Bar graph reporting the operative levels as well as direct access to the disc and release of the anterior longitudinal ligament (ALL), placement of cages with a wider footprint and possibility of achieving better restoration of lumbar lordosis [23]. During anterior approaches, the thoracoabdominal aorta, vena cava, iliac vein, and segmental vessels are mobilized and retracted to reach the anterior surface of the spine, for levels above L5-S1.…”

Section: Anterior Approachesmentioning

confidence: 99%

Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

et al. 2021

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Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

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Effect of Smoking Status on Successful Arthrodesis, Clinical Outcome, and Complications After Anterior Lumbar Interbody Fusion (ALIF)

Cited by 33 publications

References 29 publications

Development of a model to predict the probability of incurring a complication during spine surgery

Development of a model to predict the probability of incurring a complication during spine surgery

Efficacy of Biocage in treating single-segment lumbar degenerative disease in patients with high risk of non-fusion: a prospective controlled study with at least 2 years’ follow-up

Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

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