Sharma Mayur, Jain Nikhil, Wang Dengzhi, Ugiliweneza Beatrice, Boakye Maxwell
Neurosurgery, University of Louisville School of Medicine, Louisville, USA.
Neurosurgery, University of Minnesota School of Medicine, Minneapolis, USA.
Cureus. 2023 Jan 25;15(1):e34194. doi: 10.7759/cureus.34194. eCollection 2023 Jan.
A variety of surgical approaches (anterior vs. posterior vs. anterior and posterior) are available for Isthmic Spondylolisthesis (IS). The aim of our study was to analyze the pattern and 30-day outcomes in patients undergoing different surgical approaches for single-level IS.
National Surgical Quality Improvement Program (NSQIP) database was queried using the ICD-9/10 and CPT 4 edition, from 2012 to 2020. We included patients 18-65 years of age who underwent spine fusions for IS. Outcomes were a length of stay (LOS), discharge disposition, 30-day complications, hospital readmission, and complication rates.
Of 1036 patients who underwent spine fusions for IS, 838 patients (80.8%) underwent posterior only, 115 patients (11.1%) underwent anterior-only fusions and the rest (8%) underwent combined anterior and posterior procedures. 60% of patients in the posterior-only cohort had at least one comorbidity compared to 54% of patients in anterior only and 55% of patients in the combined cohort. No statistically significant differences in terms of LOS (3 days each) and discharge to home (96% vs. 93% vs. 94%) were noted among the anterior-only, posterior-only and combined cohorts, p> 0.05. In terms of 30-day complication rates, combined procedures had slightly higher rates (13%) compared to anterior (10%) or posterior-only (9%) procedures.
Posterior-only fusions were performed in 80% of patients with IS. No differences in terms of LOS, discharge disposition to home, 30-day complications, hospital readmission and reoperation rates were noted across the cohorts.
对于峡部裂型腰椎滑脱症（IS），有多种手术入路可供选择（前路、后路、前后联合）。我们研究的目的是分析接受不同手术入路治疗单节段IS患者的手术方式及30天的预后情况。
使用ICD - 9/10和CPT第4版，查询2012年至2020年的国家外科质量改进计划（NSQIP）数据库。我们纳入了18至65岁因IS接受脊柱融合术的患者。观察指标包括住院时间（LOS）、出院去向、30天并发症、再次入院情况及并发症发生率。
在1036例因IS接受脊柱融合术的患者中，838例（80.8%）仅接受了后路手术，115例（11.1%）仅接受了前路融合术，其余（8%）接受了前后联合手术。仅接受后路手术组60%的患者至少有一种合并症，仅接受前路手术组为54%，联合手术组为55%。在仅接受前路、仅接受后路和联合手术组之间，住院时间（均为3天）和出院回家比例（分别为96%、93%、94%）方面未观察到统计学显著差异，p>0.05。在30天并发症发生率方面，联合手术组（13%）略高于前路手术组（10%）或仅后路手术组（9%）。
80%的IS患者接受了仅后路融合术。各队列在住院时间、出院回家情况、30天并发症、再次入院及再次手术率方面未观察到差异。
