P292. Single-staged versus multi-staged lumbar 360 fusion surgery: a Michigan Spine Surgery Improvement Collaborative (MSSIC) study

• Published in: The spine journal 2024-09, Vol.24 (9), p.S207-S207
• Main Authors: Kagithala, Dheeraj, Chaker, Anisse, Melhem, Melhem, Abdulhak, Muwaffak, Hu, Jianhui, Schultz, Lonni R, Schwalb, Jason M, Mansour, Tarek, Telemi, Edvin, Rademacher, Anneliese, Chang, Victor
• Format: Article
• Language: English
• ISSN: 1529-9430
• DOI: 10.1016/j.spinee.2024.06.415

Patients undergoing anterior/posterior lumbar fusion surgery can undergo either a single-stage or multi-stage operation depending on surgeon preference. There is limited evidence directly comparing outcomes between single- and multi-stage lumbar fusion surgery. To assess differences in outcomes between patients who underwent single- versus multi-stage lumbar fusion procedures in a multi-center setting. Not Applicable Not Applicable Not Applicable The Michigan Spine Surgery Improvement Collaborative database was queried for lumbar fusion surgeries between July 2018 and January 2022. Patients who underwent single-stage and multi-stage procedures were included. Primary outcomes included postoperative complications and improvement in patient-reported outcomes (PROs) which include: NASS patient satisfaction, PROMIS Physical Function, and EQ-5D. Propensity matching was conducted followed by Poisson generalized estimating equation models for multivariate analyses. Following propensity matching, 355 patients underwent single-stage procedures and 355 patients underwent multi-stage procedures. Patients undergoing multi-stage procedures had more complications, less patient satisfaction after 1 year, and were less likely to experience improvement in back pain after 90 days and at 2 years (1.17[1.02-1.34, p = 0.026], 0.83[0.74-0.93, p < 0.001], 0.86[0.75-0.99, p = 0.039], and 0.76[0.60-0.96, p = 0.023], respectively). On a matched cohort of patients undergoing lumbar 360 fusion, we observed that patients who undergo a multi-stage approach have higher postoperative complication rates and lower patient satisfaction compared to those who underwent single-stage procedures. Our findings suggest that single-stage lumbar 360 fusion surgery is tolerated well, if not better, than the multi-staged approach. This abstract does not discuss or include any applicable devices or drugs.