Medical Student USF Health Morsani College of Medicine Tampa, FL, US
Disclosure(s):
Bryan Clampitt, BS: No financial relationships to disclose
Introduction: Minimally invasive spine surgery (MIS) for adult spinal deformity (ASD) utilizes percutaneous fixation and smaller incisions, aiming to reduce perioperative morbidity and complications compared to traditional open procedures. However, the safety and efficacy of MIS in managing ASD complications, including hardware failure (HF), require thorough evaluation.
Methods: A retrospective review was conducted on all spinal deformity surgeries at our tertiary care center from 2016 to 2023. MIS was defined as deformity surgery using percutaneous screws, while open procedures involved full midline incisions for hardware placement. ASD was characterized by constructs with an upper instrumented vertebra (UIV) of L2 or higher and a lower instrumented vertebra (LIV) of S1 or pelvis. HF data, including pseudoarthrosis, rod fractures, and other hardware failures, were collected from radiologic reports. Statistical analyses were performed using SPSS.
Results: Data from 265 patients (mean age 64.3 years, 56% male) were analyzed, with 36 patients undergoing MIS (13.6%). The mean number of fused levels was 6.3±1.6 for MIS and 8.5±3.3 for open approaches. HF occurred in 13 MIS patients (36.1%) compared to 86 open surgery patients (37.6%). PJK developed in 3 MIS cases (8.3%) versus 21 open surgery cases (9.2%). MIS did not significantly correlate with overall HF (OR 0.94, 95% CI 0.45-1.95). However, MIS patients were less likely to experience screw fractures (MIS: 0 patients; open: 9 (3.9%); OR 0.96, 95% CI 0.94-0.99).
Conclusion : Both MIS and open approaches for ASD treatment exhibit variable outcomes influenced by multiple factors. Our study found no significant difference in overall HF rates between MIS and open surgery, except for a lower incidence of screw fractures in MIS cases. These findings underscore the importance of careful patient selection and surgical technique to minimize complications in ASD management.