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. 2017 Oct;7(7):703-708.
doi: 10.1177/2192568217716151. Epub 2017 Jul 28.

Is There a Patient Profile That Characterizes a Patient With Adult Spinal Deformity as a Candidate for Minimally Invasive Surgery?

Robert K Eastlack  1   2 , Gregory M Mundis Jr  1   2 , Michael Wang  3 , Praveen V Mummaneni  4 , Juan Uribe  5 , David Okonkwo  6 , Behrooz A Akbarnia  2 , Neel Anand  7 , Adam Kanter  6 , Paul Park  8 , Virginie Lafage  9 , Christopher Shaffrey  10 , Richard Fessler  11 , Vedat Deviren  4 ; International Spine Study Group
Affiliations

Is There a Patient Profile That Characterizes a Patient With Adult Spinal Deformity as a Candidate for Minimally Invasive Surgery?

Robert K Eastlack et al. Global Spine J. 2017 Oct.

Abstract

Study design: Retrospective review.

Objectives: The goal of this study was to evaluate the baseline characteristics of patients chosen to undergo traditional open versus minimally invasive surgery (MIS) for adult spinal deformity (ASD).

Methods: A multicenter review of 2 databases including ASD patients treated with surgery. Inclusion criteria were age >45 years, Cobb angle minimum of 20°, and minimum 2-year follow-up. Preoperative radiographic parameters and disability outcome measures were reviewed.

Results: A total of 350 patients were identified: 173 OPEN patients and 177 MIS. OPEN patients were significantly younger than MIS patients (61.5 years vs 63.74 years, P = .013). The OPEN group had significantly more females (87% vs 76%, P = .006), but both groups had similar body mass index. Preoperative lumbar Cobb was significantly higher for the OPEN group (34.2°) than for the MIS group (26.0°, P < .001). The mean preoperative Oswestry Disability Index was significantly higher in the MIS group (44.8 in OPEN patients and 49.8 in MIS patients, P < .011). The preoperative Numerical Rating Scale value for back pain was 7.2 in the OPEN group and 6.8 in the MIS group preoperatively, P = .100.

Conclusions: Patients chosen for MIS for ASD are slightly older and have smaller coronal deformities than those chosen for open techniques, but they did not have a substantially lesser degree of sagittal malalignment. MIS surgery was most frequently utilized for patients with an sagittal vertical axis under 6 cm and a baseline pelvic incidence and lumbar lordosis mismatch under 30°.

Keywords: adult deformity; adult scoliosis; minimally invasive.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Anteroposterior and lateral long-alignment films of a patient in the cMIS subgroup preoperatively (A) and postoperatively (B). Reprinted with permission from Behrooz A. Akbarnia, MD, San Diego Center for Spinal Disorders.
Figure 2.
Figure 2.
Anteroposterior and lateral long-alignment films of a patient in the OPEN subgroup preoperatively (A) and postoperatively (B). Reprinted with permission from Behrooz A. Akbarnia, MD, San Diego Center for Spinal Disorders.
See this image and copyright information in PMC

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