使用个性化椎间孔镜治疗的畸形患者的放射学对齐情况:COMPASS 登记的早期经验。

IF 1.7 Q2 SURGERY
Roland S Kent, Christopher P Ames, Jahangir Asghar, Donald J Blaskiewicz, Joseph A Osorio, Chun-Po Yen, Jeffrey Mullin, Justin S Smith, John M Small, Michele Temple-Wong, Jeffrey D Schwardt
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引用次数: 0

摘要

背景:文献支持需要改进技术来实现脊柱骨盆对齐,并降低成人脊柱畸形(ASD)患者的并发症发生率。为满足这一需求,我们开发了个性化椎间孔镜设备,并在多中心个性化椎间孔镜(COMPASS)脊柱手术(COMPASS(TM suprascript))临床结果测量登记中进行评估。本报告介绍了COMPASS术前和术后矢状对位的中期结果,以及诊断为脊柱畸形并接受手术治疗的COMPASS亚群患者的并发症发生率:COMPASS 是一项市场后观察登记,患者在指数手术之前或之后登记,然后进行 24 个月的前瞻性随访。用SRS-Schwab修正器评估骨盆内陷减去腰椎前凸、骨盆倾斜和T1骨盆角的矢状对齐情况。利用 SRS-Schwab 改良因子的总和将整体畸形状态分为轻度、中度或重度。并发症摘自患者病历:研究包括来自 9 个中心的 67 名患者。66%的患者术前出现严重畸形。指标手术包括通过前路、侧路或经椎孔路植入中位数为2的个性化椎间器械,以及中位数为8的后路器械水平。术后整体矢状排列得到改善,SRS-Schwab修正因子的平均总和显著下降,这与骨盆内陷减去腰椎前凸的改善密切相关。在44名术前整体严重畸形的患者中,16人的畸形改善为中度,9人的畸形改善为轻度。13名患者(19.4%)出现了并发症,其中1例为机械性并发症,需要在术后9个月进行翻修,无一例与个性化椎间孔镜装置有关:本研究表明,使用个性化椎间孔镜进行治疗的 ASD 患者术后对位状况良好,与已发表的结果相当,且没有出现与个性化椎间孔镜相关的并发症:这项研究为越来越多的证据做出了贡献,即个性化椎间孔镜通过直接调整相邻椎体的方向,有助于改善ASD患者的矢状对位:3:
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Radiographic Alignment in Deformity Patients Treated With Personalized Interbody Devices: Early Experience From the COMPASS Registry.

Background: Literature supports the need for improved techniques to achieve spinopelvic alignment and reduce complication rates in patients with adult spinal deformity (ASD). Personalized interbody devices were developed to address this need and are under evaluation in the multicenter Clinical Outcome Measures in Personalized aprevo (circle R superscript) Spine Surgery (COMPASS (TM suprascript) registry. This report presents interim COMPASS pre- and postoperative sagittal alignment results and complication rates for a subcohort of COMPASS patients diagnosed and surgically treated for spinal deformity.

Methods: COMPASS is a postmarket observational registry of patients enrolled either before or after index surgery and then followed prospectively for 24 months. Sagittal alignment was assessed with SRS-Schwab modifiers for pelvic incidence minus lumbar lordosis, pelvic tilt, and T1 pelvic angle. Summed SRS-Schwab modifiers were utilized to assign overall deformity status as mild, moderate, or severe. Complications were extracted from patient medical records.

Results: The study included 67 patients from 9 centers. Preoperative severe deformity was observed in 66% of patients. Index surgeries included implantation of a median of 2 personalized interbody devices by anterior, lateral, or transforaminal approaches and with a median of 8 posteriorly instrumented levels. Overall postoperative sagittal alignment improved with a significant decrease in the mean sum of SRS-Schwab modifiers that correlated strongly to improvements in pelvic incidence minus lumbar lordosis. Among 44 patients with preoperative severe overall deformity, 16 improved to moderate and 9 to mild deformity. Complications occurred for 13 patients (19.4%), including 1 mechanical complication requiring revision 9 months after surgery and none related to personalized interbody devices.

Conclusions: This study demonstrates that ASD patients whose treatment included personalized interbody devices can obtain favorable postoperative alignment status comparable to published results and with no complications related to the personalized interbody devices.

Clinical relevance: This study contributes to growing evidence that personalized interbody devices contribute to improved sagittal alignment in ASD patients by directly adjusting the orientation of adjacent vertebra.

Level of evidence: 3:

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来源期刊
CiteScore
3.10
自引率
0.00%
发文量
162
期刊介绍: The International Journal of Spine Surgery is the official scientific journal of ISASS, the International Intradiscal Therapy Society, the Pittsburgh Spine Summit, and the Büttner-Janz Spinefoundation, and is an official partner of the Southern Neurosurgical Society. The goal of the International Journal of Spine Surgery is to promote and disseminate online the most up-to-date scientific and clinical research into innovations in motion preservation and new spinal surgery technology, including basic science, biologics, and tissue engineering. The Journal is dedicated to educating spine surgeons worldwide by reporting on the scientific basis, indications, surgical techniques, complications, outcomes, and follow-up data for promising spinal procedures.
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