Varying Degree of Overlap Following the Critical Steps of Lumbar Fusion and Short-term Outcomes
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved..
STUDY DESIGN: Retrospective cohort.
OBJECTIVE: The present study analyzes the impact of end-overlap on short-term outcomes after single-level, posterior lumbar fusions.
SUMMARY OF BACKGROUND DATA: Few studies have evaluated how "end-overlap" (i.e., surgical overlap after the critical elements of spinal procedures, such as during wound closure) influences surgical outcomes.
METHODS: Retrospective analysis was performed on 3563 consecutive adult patients undergoing single-level, posterior-only lumbar fusion over a 6-year period at a multi-hospital university health system. Exclusion criteria included revision surgery, missing key health information, significantly elevated body mass index (>70), non-elective operations, non-general anesthesia, and unclean wounds. Outcomes included 30-day emergency department visit, readmission, reoperation, morbidity, and mortality. Univariate analysis was carried out on the sample population, then limited to patients with end-overlap. Subsequently, patients with the least end-overlap were exact-matched to patients with the most. Matching was performed based on key demographic variables-including sex and comorbid status-and attending surgeon, and then outcomes were compared between exact-matched cohorts.
RESULTS: Among the entire sample population, no significant associations were found between the degree of end-overlap and short-term adverse events. Limited to cases with any end-overlap, increasing overlap was associated with increased 30-day emergency department visits ( P =0.049) but no other adverse outcomes. After controlling for confounding variables in the demographic-matched and demographic/surgeon-matched analyses, no differences in outcomes were observed between exact-matched cohorts.
CONCLUSIONS: The degree of overlap after the critical steps of single-level lumbar fusion did not predict adverse short-term outcomes. This suggests that end-overlap is a safe practice within this surgical population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Clinical spine surgery - 36(2023), 10 vom: 01. Dez., Seite E423-E429 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Borja, Austin J [VerfasserIn] |
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| Anmerkungen: |
Date Completed 01.12.2023 Date Revised 16.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/BSD.0000000000001504 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM360588042 |
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| 245 | 1 | 0 | |a Varying Degree of Overlap Following the Critical Steps of Lumbar Fusion and Short-term Outcomes |
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| 500 | |a Date Revised 16.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a STUDY DESIGN: Retrospective cohort | ||
| 520 | |a OBJECTIVE: The present study analyzes the impact of end-overlap on short-term outcomes after single-level, posterior lumbar fusions | ||
| 520 | |a SUMMARY OF BACKGROUND DATA: Few studies have evaluated how "end-overlap" (i.e., surgical overlap after the critical elements of spinal procedures, such as during wound closure) influences surgical outcomes | ||
| 520 | |a METHODS: Retrospective analysis was performed on 3563 consecutive adult patients undergoing single-level, posterior-only lumbar fusion over a 6-year period at a multi-hospital university health system. Exclusion criteria included revision surgery, missing key health information, significantly elevated body mass index (>70), non-elective operations, non-general anesthesia, and unclean wounds. Outcomes included 30-day emergency department visit, readmission, reoperation, morbidity, and mortality. Univariate analysis was carried out on the sample population, then limited to patients with end-overlap. Subsequently, patients with the least end-overlap were exact-matched to patients with the most. Matching was performed based on key demographic variables-including sex and comorbid status-and attending surgeon, and then outcomes were compared between exact-matched cohorts | ||
| 520 | |a RESULTS: Among the entire sample population, no significant associations were found between the degree of end-overlap and short-term adverse events. Limited to cases with any end-overlap, increasing overlap was associated with increased 30-day emergency department visits ( P =0.049) but no other adverse outcomes. After controlling for confounding variables in the demographic-matched and demographic/surgeon-matched analyses, no differences in outcomes were observed between exact-matched cohorts | ||
| 520 | |a CONCLUSIONS: The degree of overlap after the critical steps of single-level lumbar fusion did not predict adverse short-term outcomes. This suggests that end-overlap is a safe practice within this surgical population | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Farooqi, Ali S |e verfasserin |4 aut | |
| 700 | 1 | |a Gallagher, Ryan S |e verfasserin |4 aut | |
| 700 | 1 | |a Detchou, Donald K E |e verfasserin |4 aut | |
| 700 | 1 | |a Glauser, Gregory |e verfasserin |4 aut | |
| 700 | 1 | |a Shultz, Kaitlyn |e verfasserin |4 aut | |
| 700 | 1 | |a McClintock, Scott D |e verfasserin |4 aut | |
| 700 | 1 | |a Malhotra, Neil R |e verfasserin |4 aut | |
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