Revision Extension of Fusion Surgery in Thoracolumbar Spine Using a Newly Designed Revision Rod - Comparative Matched Cohort Study Versus Implant-Replacement Surgery

초록

Study design Retrospective cohort study. Objective To compare the results of revision extension of fusion surgery using the newly designed revision rod and implant-replacement surgery in thoracolumbar spine. Methods Thirty-one patients who underwent extension of fusion surgery using the revision rod for adjacent segment disease were included in this study. Thirty-one patients who underwent implant-replacement revision surgery were selected as a control group by matching age, sex, preoperative diagnosis, and number of revision segments. Results The mean age was 70.7 +/- 8.0 years in the revision rod (RR) group and 69.0 +/- 8.4 years in the control group. Preoperative diagnoses, underlying diseases, and mean number of revision segments (2.2 +/- 1.1) were similar in both groups. The change of hemoglobin (1.0 +/- 1.9 vs 2.5 +/- 1.5 g/dl; P < .01), hematocrit (4.1 +/- 4.9 vs 7.2 +/- 4.4 % P < .01) and albumin (.8 +/- .9 vs 1.3 +/- .4 g/dl; P < .01) levels before and after surgery showed significant differences between the two groups. Hemovac drainage was significantly less in the RR group (P = .01). The mean operative time was shorter in the RR group (203.5 +/- 9.5 min vs 233.5 +/- 8.7 min; P = .12) with no statistical difference. Radiological results showed that the average lumbar lordosis 2 years after surgery was lower in the RR group compared to the control group (25.1 +/- 9.9 degrees vs 32.9 +/- 9.8 degrees; P = .02). Union rates and clinical outcomes were not different between the two groups. Conclusions Revision extension of fusion surgery using a newly designed revision rod had less hemovac drainage and superior laboratory findings compared to implant-replacement revision surgery.

키워드