Trends in lumbar spinal fusion—a literature review

Reisener, Marie–Jacqueline; Pumberger, Matthias; Shue, Jennifer; Girardi, Federico P.; Hughes, Alexander P.

doi:10.21037/jss-20-492

Cited by 131 publications

(103 citation statements)

References 89 publications

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“…This study has shown an increase in emergency surgeries for degenerative pathology over time. This may be the result of increasing demand for spinal surgeries, disproportionate to the limited resources available to provide them [ 37 , 38 ]. Compromised access to surgeons whose waitlists for assessment and elective surgery are inundated with patients may lead to increases in patients with degenerative spinal pathology that would ideally be treated electively, presenting to emergency rooms in states of crisis.…”

Section: Discussionmentioning

confidence: 99%

Variations in LOS and its main determinants overtime at an academic spinal care center from 2006–2019

et al. 2022

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Objectives Efforts to safely reduce hospital LOS while maintaining quality outcomes and patient satisfaction are paramount. The primary goal of this study was to assess trends in LOS at a high-volume quaternary care spine center. Secondary goals were to assess trends in factors most associated with prolonged LOS. Methods This is a prospective study of all consecutive patients admitted from January 2006 to December 2019. Data included demographics, diagnostic category (degenerative, oncology, deformity, trauma, other), LOS (mean, median, interquartile range, standard deviation, defined as days from admission to discharge), and in-hospital adverse events. Results A total of 13,493 patients were included. Overall LOS has not changed over time with an overall median of 6.3 days ( p = 0.451). Median LOS significantly increased for patients treated for degenerative pathology from 2.2 days in 2006 to 3.2 days in 2019 ( p = 0.019). LOS has not changed for patients treated for deformity (overall median 6.8 days, p = 0.411), oncology (overall median 11.0 days, p = 0.051), or trauma (overall median 11.8 days, p = 0.582). Emergency admissions increased 3.2%/year for degenerative pathologies ( p = < 0.001). Mean age has increased from 48.4 years in 2006 to 58.1 years in 2019 ( p = < 0.001). This trend was observed in the deformity, degenerative and trauma group, not for patients treated for oncological disease. More adverse events were significantly associated with increasing age. Conclusion This is the first North American study to comprehensively analyze trends in LOS for spinal surgery overtime in an academic center. Overall, LOS has not changed from 2006–2019. Various factors that influence LOS appear to have balanced each other. It may also be explained by the changing epidemiology of both elective and emergency surgeries. These findings provide opportunities for intervention and improvement, targeted at the geriatric population, to reduce length of hospitalization.

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Section: Discussionmentioning

confidence: 99%

Variations in LOS and its main determinants overtime at an academic spinal care center from 2006–2019

et al. 2022

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“…When bone grafting, iliac bone was slightly higher than the height of intervertebral space or bone groove between the vertebrae. It helps provide sufficiently stable after grafting [ 29 ]. In this study, there was no incidence of internal fixation or bone graft failure in patients receiving this surgery.…”

Section: Discussionmentioning

confidence: 99%

One-stage freehand minimally invasive pedicle screw fixation combined with mini-access surgery through OLIF approach for the treatment of lumbar tuberculosis

et al. 2022

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Objective To compare one-stage freehand minimally invasive pedicle screw fixation (freehand MIPS) combined with mini-access surgery through OLIF approach with posterior approach for treatment of lumbar tuberculosis (TB), and evaluate its feasibility, efficacy and safety in debridement, bone graft fusion and internal fixation. Methods 48 patients with single segment lumbar TB from June 2014 to June 2017 were included. Among them, 22 patients underwent one-stage freehand MIPS combined with mini-access surgery through OLIF approach (group 1), 26 patients were treated with posterior open surgery (group 2). Duration of operation, blood loss, and stay time in hospital were compared. Pre- and postoperative visual analog scale (VAS) pain scores, Oswestry disability index (ODI), erythrocyte sedimentation rate, complications and images were also recorded. Results Patients in group 1 showed significantly less blood loss (165 ± 73 ml vs 873 ± 318 ml, P < 0.001), shorter stay time in hospital (6/4–8 days vs 12/8–15 days, P < 0.001), while longer duration of operation (185 ± 14 min vs 171 ± 12 min, P < 0.001) than group 2 did. VAS scores significantly decreased after surgery in both groups, however, VAS scores of group 1 were significantly lower than that of group 2 immediately after surgery and during follow-ups (P < 0.001). ODI of group 1 was also significantly lower than that of group 2 at 12-month after surgery (P < 0.001). Conclusion One-stage freehand MIPS combined with mini-access surgery through OLIF approach is a feasible, efficient and safe method in treating single segment lumbar TB. It shows advantages of less surgical trauma and faster postoperative recovery.

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“…All techniques aimed to immobilize the painful degenerated spinal segments and restore disc height and root canal dimensions, as well as load bearing ability of the anterior structures . [15][16][17] Although several comparative studies described in the literature between the discectomy and fusion techniques, only two comparative studies found in the literature that comparing discectomy alone versus discectomy with TLIF and transpedicular fixation 18,19 . El Shazly et al 18 conducted a prospective study to compare discectomy alone versus discectomy and fusion with TLIF or posterolateral interbody fusion (PLIF) and found no significant differences in outcomes between groups after a mean of 37 months of follow up.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study between the Outcomes of Posterior Lumbar Interbody Fusion Combined with Transpedicular Screws versus Transpedicular Screws Alone in Recurrent Lumbar Disc Prolapse

Alhady

Abo-Shahba

Salama

2021

Al-Azhar International Medical Journal

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Trends in lumbar spinal fusion—a literature review

Cited by 131 publications

References 89 publications

Variations in LOS and its main determinants overtime at an academic spinal care center from 2006–2019

Variations in LOS and its main determinants overtime at an academic spinal care center from 2006–2019

One-stage freehand minimally invasive pedicle screw fixation combined with mini-access surgery through OLIF approach for the treatment of lumbar tuberculosis

Comparative Study between the Outcomes of Posterior Lumbar Interbody Fusion Combined with Transpedicular Screws versus Transpedicular Screws Alone in Recurrent Lumbar Disc Prolapse

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