Comparative Analysis of Inpatient Opioid Consumption Between Different Surgical Approaches Following Single Level Lumbar Spinal Fusion Surgery.

Autor:	Zabat MA; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Mottole NA; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Ashayeri K; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Norris ZA; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Patel H; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Sissman E; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Balouch E; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Maglaras C; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Protopsaltis TS; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Buckland AJ; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA., Fischer CR; Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	Global spine journal [Global Spine J] 2023 Oct; Vol. 13 (8), pp. 2508-2515. Date of Electronic Publication: 2022 Apr 05.
DOI:	10.1177/21925682221089244
Abstrakt:	Study Design: Single-center retrospective cohort study. Objectives: To evaluate inpatient MME administration associated with different lumbar spinal fusion surgeries. Methods: Patients ≥18 years of age with a diagnosis of Grade I or II spondylolisthesis, stenosis, degenerative disc disease or pars defect who underwent one-level Transforaminal Lumbar Interbody Fusion (TLIF) or one-level Anterior Lumbar Interbody Fusion (ALIF) or Lateral Lumbar Interbody Fusion (LLIF) through traditional MIS, anterior-posterior position or single position approaches between L2-S1. Outcome measures included patient demographics, surgical procedure and approach, perioperative clinical characteristics, incidence of ileus and inpatient MME. Statistical analysis included one-way ANOVA with a post-hoc Tukey Test and Kruskal-Wallis Test with post-hoc Mann-Whitney test. MME was calculated as per the Centers for Medicare and Medicaid Services and previous literature. Significance set at P < .05. Results: Mean age differed significantly between MIS TLIF (55.6 ± 12.5 years) and all other groups (Open TLIF 57.1 ± 12.5, SP ALIF/LLIF 57.9 ± 9.9, TP ALIF/LLIF 50.9 ± 12.7, Open ALIF/LLIF 58.4 ± 15.5). MIS TLIF had the shortest LOS compared to all groups except SP ALIF/LLIF. Total MME was significantly different between MIS TLIF and Open ALIF/LLIF (172.5 MME vs 261.1 MME, P = .044) as well as MIS TLIF and TP ALIF/LLIF (172.5 MME vs 245.4 MME, P = .009). There were no significant differences in MME/hour and incidence of ileus between all groups. Conclusion: Patients undergoing MIS TLIF had lower inpatient opioid intake compared to TP and SP ALIF/LLIF, as well as shorter LOS compared to all groups except SP ALIF/LLIF. Thus, it appears that the advantages of minimally invasive surgery are seen in minimally invasive TLIFs.
Databáze:	MEDLINE
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