Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine?
Objectives: Anterior spinal fusion (ASF) presents unique challenges, including the proximity of critical anatomic structures. Previous reports have detailed vascular injuries during exposure/approach; however, it is not well-documented whether structural aortic pathology, such as aneurysm, dissectio...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2024-12-01
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| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jcvjs.jcvjs_134_24 |
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| author | Neil V. Shah Pelin Çeliker Cirous Sadeghi Rachel Baum Juhayer S. Alam Chibuokem Ikwuazom Peter L. Zhou Benjamin Krasnyanskiy David Kim Rohan Desai Sandeep Bains Jeffrey M. Schwartz Bassel G. Diebo Carl B. Paulino |
| author_facet | Neil V. Shah Pelin Çeliker Cirous Sadeghi Rachel Baum Juhayer S. Alam Chibuokem Ikwuazom Peter L. Zhou Benjamin Krasnyanskiy David Kim Rohan Desai Sandeep Bains Jeffrey M. Schwartz Bassel G. Diebo Carl B. Paulino |
| author_sort | Neil V. Shah |
| collection | DOAJ |
| description | Objectives:
Anterior spinal fusion (ASF) presents unique challenges, including the proximity of critical anatomic structures. Previous reports have detailed vascular injuries during exposure/approach; however, it is not well-documented whether structural aortic pathology, such as aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors, impacts postoperative outcomes following anterior approach to the spine for spinal fusion.
Materials and Methods:
Using the New York State Statewide Planning and Research Cooperative System, thoracolumbar ASF patients with a history of aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors (APath) were identified and matched to patients with no aortic pathologies (No-APath). The two cohorts were compared at 90-day and 2-year follow-up for complications, readmissions, and revisions. Multivariate binary stepwise logistic regression identified independent predictors of these outcomes.
Results:
Ninety-nine and 64 patients were included at 90-day and 2-year follow-ups, respectively. APath and No-APath had comparable demographics. Through 90-day follow-up, both cohorts had similar vascular complications and overall complications. No-APath patients had higher surgical complications (11.1% vs. 0%, P = 0.021). At 2-year follow-up, cohorts had comparable vascular complications, overall complications, and all other outcomes (P > 0.05). Neither group was observed to require any revisions through 2-year follow-up. The presence of a structural aortic pathology was not associated with increased odds of incurring adverse outcomes at 90-day and 2-year follow-ups.
Conclusions:
Structural aortic compromise in the setting of thoracolumbar ASF did not predispose patients to adverse vascular, spinal-related, or medical/surgical complications, nor to anterior spinal or vascular revision or repair through 2-year follow-up. These results highlight the need for well-powered studies to further delineate the risk of anterior spinal surgery in this cohort of patients. |
| format | Article |
| id | doaj-art-38fcdcf7866540e1a539f569df8b7953 |
| institution | Kabale University |
| issn | 0974-8237 0976-9285 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj-art-38fcdcf7866540e1a539f569df8b79532025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115443744210.4103/jcvjs.jcvjs_134_24Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine?Neil V. ShahPelin ÇelikerCirous SadeghiRachel BaumJuhayer S. AlamChibuokem IkwuazomPeter L. ZhouBenjamin KrasnyanskiyDavid KimRohan DesaiSandeep BainsJeffrey M. SchwartzBassel G. DieboCarl B. PaulinoObjectives: Anterior spinal fusion (ASF) presents unique challenges, including the proximity of critical anatomic structures. Previous reports have detailed vascular injuries during exposure/approach; however, it is not well-documented whether structural aortic pathology, such as aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors, impacts postoperative outcomes following anterior approach to the spine for spinal fusion. Materials and Methods: Using the New York State Statewide Planning and Research Cooperative System, thoracolumbar ASF patients with a history of aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors (APath) were identified and matched to patients with no aortic pathologies (No-APath). The two cohorts were compared at 90-day and 2-year follow-up for complications, readmissions, and revisions. Multivariate binary stepwise logistic regression identified independent predictors of these outcomes. Results: Ninety-nine and 64 patients were included at 90-day and 2-year follow-ups, respectively. APath and No-APath had comparable demographics. Through 90-day follow-up, both cohorts had similar vascular complications and overall complications. No-APath patients had higher surgical complications (11.1% vs. 0%, P = 0.021). At 2-year follow-up, cohorts had comparable vascular complications, overall complications, and all other outcomes (P > 0.05). Neither group was observed to require any revisions through 2-year follow-up. The presence of a structural aortic pathology was not associated with increased odds of incurring adverse outcomes at 90-day and 2-year follow-ups. Conclusions: Structural aortic compromise in the setting of thoracolumbar ASF did not predispose patients to adverse vascular, spinal-related, or medical/surgical complications, nor to anterior spinal or vascular revision or repair through 2-year follow-up. These results highlight the need for well-powered studies to further delineate the risk of anterior spinal surgery in this cohort of patients.https://journals.lww.com/10.4103/jcvjs.jcvjs_134_24aortacomplicationsfusionspinethoracolumbar |
| spellingShingle | Neil V. Shah Pelin Çeliker Cirous Sadeghi Rachel Baum Juhayer S. Alam Chibuokem Ikwuazom Peter L. Zhou Benjamin Krasnyanskiy David Kim Rohan Desai Sandeep Bains Jeffrey M. Schwartz Bassel G. Diebo Carl B. Paulino Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? Journal of Craniovertebral Junction and Spine aorta complications fusion spine thoracolumbar |
| title | Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? |
| title_full | Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? |
| title_fullStr | Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? |
| title_full_unstemmed | Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? |
| title_short | Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine? |
| title_sort | does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine |
| topic | aorta complications fusion spine thoracolumbar |
| url | https://journals.lww.com/10.4103/jcvjs.jcvjs_134_24 |
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