Rudisill Samuel S, Massel Dustin H, Hornung Alexander L, Kia Cameron, Patel Karan, Aboushaala Khaled, Chukwuemeka Mbagwu, Wong Arnold Y L, Barajas J Nicolas, Mallow G Michael, Toro Sheila J, Singh Harmanjeet, Gawri Rahul, Louie Philip K, Phillips Frank M, An Howard S, Samartzis Dino
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA.
The International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, USA.
Eur Spine J. 2025 Jan;34(1):170-181. doi: 10.1007/s00586-024-08516-y. Epub 2024 Oct 14.
This study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs).
An ambispective study was performed. Patients who underwent posterolateral or posterior lumbar interbody fusion were included. Demographic, perioperative and postoperative, clinical, and blood type information was recorded. Pre- and post-operative radiographic imaging was analyzed for alignment parameters and development of ASD.
445 patients were included, representing O+ (36.0%), O- (5.2%), A+ (36.2%), A- (6.3%), B+ (12.1%), B- (1.6%), and AB+ (2.7%) blood types. Most patients were female (59.1%), and had a mean age of 60.3 years and BMI of 31.1 kg/m. Postoperatively, groups did not differ in duration of the hospital (p = 0.732) or intensive care unit (p = 0.830) stay, discharge disposition (p = 0.504), reoperation rate (p = 0.192), or in-hospital complication rate (p = 0.377). Postoperative epidural hematoma was most common amongst A + patients (p = 0.024). Over a mean of 11.0 months of follow-up, all patients exhibited similar improvement in PROMs, with 132 (29.7%) patients developing radiographic evidence of ASD. B + patients were significantly more likely than A + and O + patients to develop spondylolisthesis and ASD (p < 0.05). No significant differences in sagittal alignment parameters and number of levels of fusion were found (p > 0.05).
This is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.
本研究旨在探讨ABO血型与腰椎融合术后相邻节段退变/疾病（ASD）之间的关联，并评估矢状面骨盆排列、围手术期护理、术后并发症以及患者报告结局指标（PROMs）的差异。
进行了一项回顾性队列研究。纳入接受后外侧或后路腰椎椎间融合术的患者。记录人口统计学、围手术期和术后、临床及血型信息。分析术前和术后影像学检查的排列参数及ASD的发生情况。
共纳入445例患者，血型分布为O+（36.0%）、O-（5.2%）、A+（36.2%）、A-（6.3%）、B+（12.1%）、B-（1.6%）和AB+（2.7%）。大多数患者为女性（59.1%），平均年龄60.3岁，体重指数31.1kg/m。术后，各血型组在住院时间（p = 0.732）、重症监护病房停留时间（p = 0.830）、出院处置（p = 0.504）、再次手术率（p = 0.192）或院内并发症发生率（p = 0.377）方面无差异。术后硬膜外血肿在A+血型患者中最为常见（p = 0.024）。平均随访11.0个月时，所有患者的PROMs均有相似改善，132例（29.7%）患者出现ASD的影像学证据。B+血型患者发生椎体滑脱和ASD的可能性显著高于A+和O+血型患者（p < 0.05）。矢状面排列参数和融合节段数无显著差异（p > 0.05）。
这是第一项针对ABO血型这一不可改变的风险因素与腰椎融合术后ASD之间关联进行研究并论证原理的大规模研究。
