Planned two-stage surgery using lateral lumbar interbody fusion and posterior corrective fusion: a retrospective study of perioperative complications

• Published in: European spine journal 2021-08, Vol.30 (8), p.2368-2376
• Main Authors: Yamato, Yu, Hasegawa, Tomohiko, Yoshida, Go, Yasuda, Tatsuya, Banno, Tomohiro, Oe, Shin, Arima, Hideyuki, Mihara, Yuki, Ushirozako, Hiroki, Yamada, Tomohiro, Ide, Koichiro, Watanabe, Yuh, Matsuyama, Yukihiro
• Format: Article
• Language: English
• Subjects: Kyphosis; Medicine; Medicine & Public Health; Neurosurgery; Original Article; Patients; Scoliosis; Surgery; Surgical Orthopedics; Surgical site infections; Wound infection
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-021-06879-0

Purpose To determine the effect of planned two-stage surgery using lateral lumbar interbody fusion (LLIF) on the perioperative complication rate following corrective fusion surgery in patients with kyphoscoliosis. Methods Consecutive patients with degenerative scoliosis who underwent corrective fusion were divided into a control group that underwent single-stage posterior-only surgery and a group that underwent planned two-staged surgery with LLIF and posterior corrective fusion. We collected the patient background and surgical data and assessed the perioperative complication rates. We also investigated spinopelvic parameters and patient-reported outcome measurements (PROMs). Results One hundred and thirty-eight patients of mean age 69.8 (range, 50–84) years who met the study inclusion criteria were included. The two-stage group ( n  = 75) underwent a staged anterior–posterior surgical procedure, and the control group ( n  = 63) underwent single-stage surgery. There was no significant between-group difference in the incidence of perioperative complications, except for deep wound infection (reoperation is necessary for surgical site infection). Revision surgery within 3 months of the initial surgery was more common in the control group ( n  = 8, 12.7%) than in the two-stage group ( n  = 3, 4.0%). Spinopelvic parameters and PROMs were significantly better in the two-stage group at 2 years postoperatively. Conclusion The complication rate for planned two-stage surgery was similar to that of previous posterior-only single-stage surgery. However, early reoperation was less common, and the degree of spinal correction and clinical results were significantly better after two-stage surgery.