Comparative surgical outcomes of navigated vs non-navigated posterior spinal fusions in ankylosing spondylitis patients.

Autor: Marland H; School of Medicine, University of Galway, Galway, Ireland. Electronic address: H.marland1@nuigalway.ie., McDonnell JM; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; Trinity Centre of Biomedical Engineering, Trinity College Dublin, Dublin, Ireland., Hughes L; Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland., Morrison C; School of Medicine, University College Dublin, Dublin, Ireland., Wilson KV; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland., Cunniffe G; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland., Morris S; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland., Darwish S; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; Department of Orthopaedics, St. Vincent's University Hospital, Dublin, Ireland., Butler JS; National Spinal Injuries Unit, Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland.
Jazyk: angličtina
Zdroj: The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland [Surgeon] 2024 Jun; Vol. 22 (3), pp. 182-187. Date of Electronic Publication: 2024 Apr 06.
DOI: 10.1016/j.surge.2024.03.002
Abstrakt: Introduction: Ankylosing Spondylitis (AS) patients with acute spinal fractures represent a challenge for practicing spine surgeons due to difficult operative anatomy and susceptibility to complications.
Research Question: Does intraoperative CT-navigation improve outcomes in patients with ankylosing spondylitis undergoing surgery?
Methods: A retrospective review was carried out at our centre from 05/2016-06/2021 to identify AS patients presenting with a traumatic spinal fracture, managed surgically with posterior spinal fusion (PSF). Cohorts were categorised and compared for outcomes based on those who underwent PSF with intraoperative CT-navigation versus those surgically managed with traditional intraoperative fluoroscopy.
Results: 37 AS patients were identified. 29/37 (78.4%) underwent PSF. Intraoperative navigation was used in 14 (48.3%) cases. Mean age of the entire cohort was 67.6 years. No difference existed between the navigated and non-navigated groups for mean levels fused (5.35 vs 5.07; p ​= ​0.31), length of operation (217.9mins vs 175.3mins; p ​= ​0.07), overall length-of-stay (12 days vs 21.9 days; p ​= ​0.16), patients requiring HDU (3/14 vs 5/15; p ​= ​0.09) or ICU (5/14 vs 9/15; p ​= ​0.10), postoperative neurological improvement (1/14 vs 1/15; p ​= ​0.48) or deterioration (1/14 vs 0/15; p ​= ​0.15), intraoperative complications (2/14 vs 3/15; p ​= ​0.34), postoperative complications 4/14 vs 4/15; p ​= ​0.46), revision surgeries (3/14 vs 1/15; p ​= ​0.16) and 30-day mortality (0/14 vs 0/15).
Conclusion: This is the first study that compares surgical outcomes of navigated vs non-navigated PSFs for AS patients with an acute spinal fracture. Although limited by its retrospective design and sample size, this study highlights the non-inferiority of intraoperative navigation as a surgical aid in a challenging cohort.
Competing Interests: Declaration of competing interest None of the authors has any potential conflict of interest.
(Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: