Dr. Neel Anand conducts study on new vs. old protocols for circumferential minimally invasive surgical correction of adult spinal deformity — 10 observations

Written by Megan Wood | May 12, 2017 | Print  |

In a new study published in Spinal Deformity, Neel Anand, MD, of Los Angeles-based Cedars-Sinai Spine Center, analyzed circumferential minimally invasive surgical correction outcomes for patients with adult spinal deformity.

Dr. Anand compared a newer protocol with an older protocol, with 76 patients receiving the old protocol and 53 patients receiving the new protocol.

 

Here are 10 observations:

 

1. The old protocol patients had preoperative and latest visual analog scale scores of 6.85 and 3.45, compared to the new protocol group's scores of 6.19 and 2.27.

 

2. The Oswestry Disability Index decreased from 45.84 to 32.91 in the old protocol group and from 44.21 to 25.39 in the new protocol group.

 

3. The preoperative, latest and delta-SF physical component scores were as follows:


•    Old protocol — 35.38, 42.42 and 10.06
•    New protocol — 30.89, 39.49 and 11.93

 

4. The old protocol saw a latest Cobb angle of 11.54 degrees compared to the new protocol group's 11.12 degrees.

 

5. The old protocol's latest sagittal vertical axis was 42.85 mm compared to 30.58 mm for the new protocol.

 

6. Whereas the old protocol's latest pelvic incidence-lumbar lordosis mismatch was 15.49 mm, the new protocol's was 9 mm.

 

7.  The average preoperative sagittal vertical axes "that reliably achieved a postoperative SVA of 50 mm or less" were 84 mm for the old protocol and 119 mm for the new protocol. The maximum delta-SVAs proved to be 89 mm for the old protocol and 120 mm for the new protocol.

 

8. Dr. Anand noted fewer surgical complications for the new protocol.

 

9. The new protocol yielded improvements in radiographic scores, functional outcomes, and limits of SVA correction, suggesting "the new protocol may help improve outcomes." The researchers note the findings may be a result of their 10-year experience and learning curve advances.

 

10. Researchers concluded the findings support circumferential minimally invasive surgical strategies as alternatives for treating adult spinal deformity.

 

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