Determinants of Postoperative Spinal Height Change among Adult Spinal Deformity Patients with Long Construct Circumferential Fusion
- Author:
Colleen RENTENBERGER
1
;
Ichiro OKANO
;
Stephan N. SALZMANN
;
Toshiyuki SHIRAHATA
;
Marie-Jacqueline REISENER
;
Jennifer SHUE
;
Andrew A. SAMA
;
Frank P. CAMMISA
;
Federico P. GIRARDI
;
Alexander P. HUGHES
Author Information
- Publication Type:Clinical Study
- From:Asian Spine Journal 2021;15(2):155-163
- CountryRepublic of Korea
- Language:English
-
Abstract:
Methods:We retrospectively reviewed the clinical and imaging data of ASD patients who underwent lumbar corrective circumferential fusion of ≥3 levels (n=106). SH was defined as the vertical distance between C2 and S1 on a standing lateral image. As potential predictors of postoperative height change, the number of lateral lumbar interbody fusion (LLIF) levels, change in spino-pelvic parameters, total number of levels fused, and pedicle subtraction osteotomies (PSO) were documented. Univariate and multivariate linear regression analyses were performed to identify the predictors of postoperative height change.
Results:The mean SH change was −2.39±50.8 mm (range, −160 to 172 mm). The univariate analyses showed that the number of LLIF levels (coefficient=10.9,p =0.03), the absolute coronal vertical axis change (coefficient=0.6,p =0.01), and the absolute Cobb angle change (coefficient=−0.9,p =0.03) were significant predictors for height change. Patients with PSOs (n=14) tended to have a shorter height postoperatively (coefficient=−26.1); however, this difference was not significant (p =0.07). Multivariate analyses conducted with variables ofp <0.20 showed that pelvic tilt (PT) change is an independent contributor to SH change (coefficient=−0.99,p =0.04,R 2=0.11).
Conclusions:Utilizing a modified definition of SH used in previous AIS studies, we demonstrated that patients with ASD lose SH postoperatively and that PT change was an independent contributor of SH change.
