Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery
Background: Prior studies, comparing anterior and posterior approaches to lumbar fusion surgery, found similar fusion rates and clinical outcomes, but are limited by sample size. Further evaluation of the postoperative complications of each approach is necessary. Methods: The MSpine database by Pear...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | North American Spine Society Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666548422000853 |
| _version_ | 1828115492883136512 |
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| author | Leland C. McCluskey Ivan Angelov Victor J. Wu Sanchita Gupta Comron Saifi Mathew Cyriac |
| author_facet | Leland C. McCluskey Ivan Angelov Victor J. Wu Sanchita Gupta Comron Saifi Mathew Cyriac |
| author_sort | Leland C. McCluskey |
| collection | DOAJ |
| description | Background: Prior studies, comparing anterior and posterior approaches to lumbar fusion surgery, found similar fusion rates and clinical outcomes, but are limited by sample size. Further evaluation of the postoperative complications of each approach is necessary. Methods: The MSpine database by PearlDiver was queried using ICD-9, ICD-10, and CPT codes to identify patients who had undergone single-level anterior or posterior lumbar interbody fusion surgery. Readmission rates, ileus, lower extremity DVT, infection, pneumonia, and stroke were used to compare post-operative complications of an anterior vs. posterior approach. Results: 112,023 patients were included in this study, with 38,529 (34.4%) in the anterior group (ALIF/LLIF) and 73,494 (65.6%) in the posterior group (PLIF/TLIF). At both 30 and 90-days postoperative, patients undergoing an anterior approach to lumbar interbody fusion had a higher odds ratio of lower extremity DVT (30-day OR: 1.19, 90-day OR: 1.16; P<0.05) and ileus complication (30-day OR: 1.87, P= <.05; 90-day OR: 1.81, P<.05). At both 30 and 90-days postoperative, patients undergoing a posterior approach had a higher odds ratio of stroke (30-day: OR: 0.79, 90-day OR: 0.87; P<0.05), transfusion (30-day OR: 0.66, 90-day OR: 0.69; P<.05), infection (30-day OR: 0.88, 90-day OR: 0.91; P <.05), and pneumonia (30-day OR: 0.85, 90-day OR: 0.90; P<.05). There was no statistically significant difference in myocardial infarction or pulmonary embolism between both approaches at 30 and 90-days postoperative. Conclusions: Anterior and posterior approaches for lumbar interbody fusion were associated with differences in postoperative complications at 30 and 90-days. The complication profiles associated with each approach can inform surgeon treatment decisions based on patient profiles. |
| first_indexed | 2024-04-11T12:41:11Z |
| format | Article |
| id | doaj.art-aa1a63551d5c41fb9d2ce47fe95af89e |
| institution | Directory Open Access Journal |
| issn | 2666-5484 |
| language | English |
| last_indexed | 2024-04-11T12:41:11Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | North American Spine Society Journal |
| spelling | doaj.art-aa1a63551d5c41fb9d2ce47fe95af89e2022-12-22T04:23:30ZengElsevierNorth American Spine Society Journal2666-54842022-12-0112100182Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgeryLeland C. McCluskey0Ivan Angelov1Victor J. Wu2Sanchita Gupta3Comron Saifi4Mathew Cyriac5Department of Orthopaedic Surgery, Tulane University School of MedicineDepartment of Orthopedics and Sports Medicine, Houston Methodist HospitalDepartment of Orthopaedic Surgery, University of Texas Health Sciences Center - HoustonDepartment of Orthopaedic Surgery, Tulane University School of MedicineDepartment of Orthopedics and Sports Medicine, Houston Methodist Hospital; Corresponding author.Department of Orthopaedic Surgery, Tulane University School of MedicineBackground: Prior studies, comparing anterior and posterior approaches to lumbar fusion surgery, found similar fusion rates and clinical outcomes, but are limited by sample size. Further evaluation of the postoperative complications of each approach is necessary. Methods: The MSpine database by PearlDiver was queried using ICD-9, ICD-10, and CPT codes to identify patients who had undergone single-level anterior or posterior lumbar interbody fusion surgery. Readmission rates, ileus, lower extremity DVT, infection, pneumonia, and stroke were used to compare post-operative complications of an anterior vs. posterior approach. Results: 112,023 patients were included in this study, with 38,529 (34.4%) in the anterior group (ALIF/LLIF) and 73,494 (65.6%) in the posterior group (PLIF/TLIF). At both 30 and 90-days postoperative, patients undergoing an anterior approach to lumbar interbody fusion had a higher odds ratio of lower extremity DVT (30-day OR: 1.19, 90-day OR: 1.16; P<0.05) and ileus complication (30-day OR: 1.87, P= <.05; 90-day OR: 1.81, P<.05). At both 30 and 90-days postoperative, patients undergoing a posterior approach had a higher odds ratio of stroke (30-day: OR: 0.79, 90-day OR: 0.87; P<0.05), transfusion (30-day OR: 0.66, 90-day OR: 0.69; P<.05), infection (30-day OR: 0.88, 90-day OR: 0.91; P <.05), and pneumonia (30-day OR: 0.85, 90-day OR: 0.90; P<.05). There was no statistically significant difference in myocardial infarction or pulmonary embolism between both approaches at 30 and 90-days postoperative. Conclusions: Anterior and posterior approaches for lumbar interbody fusion were associated with differences in postoperative complications at 30 and 90-days. The complication profiles associated with each approach can inform surgeon treatment decisions based on patient profiles.http://www.sciencedirect.com/science/article/pii/S2666548422000853Anterior lumbar interbody fusionPosterior lumbar interbody fusionTransfusionPostoperative complicationsStrokeInfection |
| spellingShingle | Leland C. McCluskey Ivan Angelov Victor J. Wu Sanchita Gupta Comron Saifi Mathew Cyriac Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery North American Spine Society Journal Anterior lumbar interbody fusion Posterior lumbar interbody fusion Transfusion Postoperative complications Stroke Infection |
| title | Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery |
| title_full | Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery |
| title_fullStr | Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery |
| title_full_unstemmed | Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery |
| title_short | Anterior lumbar spinal fusion surgery associated with lower risk of stroke, pneumonia, and infection compared to posterior lumbar spinal fusion surgery |
| title_sort | anterior lumbar spinal fusion surgery associated with lower risk of stroke pneumonia and infection compared to posterior lumbar spinal fusion surgery |
| topic | Anterior lumbar interbody fusion Posterior lumbar interbody fusion Transfusion Postoperative complications Stroke Infection |
| url | http://www.sciencedirect.com/science/article/pii/S2666548422000853 |
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