The influence of common medical conditions on the outcome of anterior lumbar interbody fusion

Samuel Kalb, Luis Perez-Orribo, M. Yashar S Kalani, Laura A. Snyder, Nikolay L. Martirosyan, Keven Burns, Robert J. Standerfer, Udaya K. Kakarla, Curtis A. Dickman, Nicholas Theodore

Research output: Contribution to journalArticle

Abstract

STUDY DESIGN: The authors retrospectively reviewed a consecutive series of 231 patients with anterior lumbar interbody fusion (ALIF). OBJECTIVE: To determine the correlations among common medical conditions, demographics, and the natural history of lumbar surgery with outcomes of ALIF. SUMMARY OF BACKGROUND DATA: Multiple spinal disorders are treated with ALIF with excellent success rates. Nonetheless, adverse outcomes and complications related to patients' overall demographics, comorbidities, or cigarette smoking have been reported. METHODS: The age, sex, body mass index (BMI), comorbidities, history of smoking or previous lumbar surgery, operative parameters, and complications of 231 patients who underwent ALIF were analyzed. Regression analyses of all variables with complications and surgical outcomes based on total Prolo scores were performed. Two models predicting Prolo outcome score were generated. The first model used BMI and sex interaction, whereas the second model used sex, level of surgery, presence of diabetes mellitus, and BMI as variables. RESULTS: At follow-up, the rate of successful fusion was 99%. The overall complication rate was 13.8%, 1.8% of which occurred intraoperatively and 12% during follow-up. The incidence of complications failed to correlate with demographics, comorbidities, smoking, or previous lumbar surgery (P>0.5). ALIF at T12-L4 was the only factor significantly associated with poor patient outcomes (P=0.024). Both models successfully predicted outcome (P=0.05), although the second model did so only for males. CONCLUSIONS: Surgical level of ALIF correlated with poor patient outcomes as measured by Prolo functional scale. BMI emerged as a significant predictor of Prolo total score. Both multivariate models also successfully predicted outcomes. Surgical or follow-up complications were not associated with patients' preoperative status.

Original languageEnglish (US)
JournalJournal of Spinal Disorders and Techniques
DOIs
StateAccepted/In press - Dec 27 2012
Externally publishedYes

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Body Mass Index
Comorbidity
Smoking
Demography
Natural History
Diabetes Mellitus
Regression Analysis
Incidence

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

The influence of common medical conditions on the outcome of anterior lumbar interbody fusion. / Kalb, Samuel; Perez-Orribo, Luis; Kalani, M. Yashar S; Snyder, Laura A.; Martirosyan, Nikolay L.; Burns, Keven; Standerfer, Robert J.; Kakarla, Udaya K.; Dickman, Curtis A.; Theodore, Nicholas.

In: Journal of Spinal Disorders and Techniques, 27.12.2012.

Research output: Contribution to journalArticle

Kalb, S, Perez-Orribo, L, Kalani, MYS, Snyder, LA, Martirosyan, NL, Burns, K, Standerfer, RJ, Kakarla, UK, Dickman, CA & Theodore, N 2012, 'The influence of common medical conditions on the outcome of anterior lumbar interbody fusion', Journal of Spinal Disorders and Techniques. https://doi.org/10.1097/BSD.0b013e31827e4c85
Kalb, Samuel ; Perez-Orribo, Luis ; Kalani, M. Yashar S ; Snyder, Laura A. ; Martirosyan, Nikolay L. ; Burns, Keven ; Standerfer, Robert J. ; Kakarla, Udaya K. ; Dickman, Curtis A. ; Theodore, Nicholas. / The influence of common medical conditions on the outcome of anterior lumbar interbody fusion. In: Journal of Spinal Disorders and Techniques. 2012.
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abstract = "STUDY DESIGN: The authors retrospectively reviewed a consecutive series of 231 patients with anterior lumbar interbody fusion (ALIF). OBJECTIVE: To determine the correlations among common medical conditions, demographics, and the natural history of lumbar surgery with outcomes of ALIF. SUMMARY OF BACKGROUND DATA: Multiple spinal disorders are treated with ALIF with excellent success rates. Nonetheless, adverse outcomes and complications related to patients' overall demographics, comorbidities, or cigarette smoking have been reported. METHODS: The age, sex, body mass index (BMI), comorbidities, history of smoking or previous lumbar surgery, operative parameters, and complications of 231 patients who underwent ALIF were analyzed. Regression analyses of all variables with complications and surgical outcomes based on total Prolo scores were performed. Two models predicting Prolo outcome score were generated. The first model used BMI and sex interaction, whereas the second model used sex, level of surgery, presence of diabetes mellitus, and BMI as variables. RESULTS: At follow-up, the rate of successful fusion was 99{\%}. The overall complication rate was 13.8{\%}, 1.8{\%} of which occurred intraoperatively and 12{\%} during follow-up. The incidence of complications failed to correlate with demographics, comorbidities, smoking, or previous lumbar surgery (P>0.5). ALIF at T12-L4 was the only factor significantly associated with poor patient outcomes (P=0.024). Both models successfully predicted outcome (P=0.05), although the second model did so only for males. CONCLUSIONS: Surgical level of ALIF correlated with poor patient outcomes as measured by Prolo functional scale. BMI emerged as a significant predictor of Prolo total score. Both multivariate models also successfully predicted outcomes. Surgical or follow-up complications were not associated with patients' preoperative status.",
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AU - Martirosyan, Nikolay L.

AU - Burns, Keven

AU - Standerfer, Robert J.

AU - Kakarla, Udaya K.

AU - Dickman, Curtis A.

AU - Theodore, Nicholas

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N2 - STUDY DESIGN: The authors retrospectively reviewed a consecutive series of 231 patients with anterior lumbar interbody fusion (ALIF). OBJECTIVE: To determine the correlations among common medical conditions, demographics, and the natural history of lumbar surgery with outcomes of ALIF. SUMMARY OF BACKGROUND DATA: Multiple spinal disorders are treated with ALIF with excellent success rates. Nonetheless, adverse outcomes and complications related to patients' overall demographics, comorbidities, or cigarette smoking have been reported. METHODS: The age, sex, body mass index (BMI), comorbidities, history of smoking or previous lumbar surgery, operative parameters, and complications of 231 patients who underwent ALIF were analyzed. Regression analyses of all variables with complications and surgical outcomes based on total Prolo scores were performed. Two models predicting Prolo outcome score were generated. The first model used BMI and sex interaction, whereas the second model used sex, level of surgery, presence of diabetes mellitus, and BMI as variables. RESULTS: At follow-up, the rate of successful fusion was 99%. The overall complication rate was 13.8%, 1.8% of which occurred intraoperatively and 12% during follow-up. The incidence of complications failed to correlate with demographics, comorbidities, smoking, or previous lumbar surgery (P>0.5). ALIF at T12-L4 was the only factor significantly associated with poor patient outcomes (P=0.024). Both models successfully predicted outcome (P=0.05), although the second model did so only for males. CONCLUSIONS: Surgical level of ALIF correlated with poor patient outcomes as measured by Prolo functional scale. BMI emerged as a significant predictor of Prolo total score. Both multivariate models also successfully predicted outcomes. Surgical or follow-up complications were not associated with patients' preoperative status.

AB - STUDY DESIGN: The authors retrospectively reviewed a consecutive series of 231 patients with anterior lumbar interbody fusion (ALIF). OBJECTIVE: To determine the correlations among common medical conditions, demographics, and the natural history of lumbar surgery with outcomes of ALIF. SUMMARY OF BACKGROUND DATA: Multiple spinal disorders are treated with ALIF with excellent success rates. Nonetheless, adverse outcomes and complications related to patients' overall demographics, comorbidities, or cigarette smoking have been reported. METHODS: The age, sex, body mass index (BMI), comorbidities, history of smoking or previous lumbar surgery, operative parameters, and complications of 231 patients who underwent ALIF were analyzed. Regression analyses of all variables with complications and surgical outcomes based on total Prolo scores were performed. Two models predicting Prolo outcome score were generated. The first model used BMI and sex interaction, whereas the second model used sex, level of surgery, presence of diabetes mellitus, and BMI as variables. RESULTS: At follow-up, the rate of successful fusion was 99%. The overall complication rate was 13.8%, 1.8% of which occurred intraoperatively and 12% during follow-up. The incidence of complications failed to correlate with demographics, comorbidities, smoking, or previous lumbar surgery (P>0.5). ALIF at T12-L4 was the only factor significantly associated with poor patient outcomes (P=0.024). Both models successfully predicted outcome (P=0.05), although the second model did so only for males. CONCLUSIONS: Surgical level of ALIF correlated with poor patient outcomes as measured by Prolo functional scale. BMI emerged as a significant predictor of Prolo total score. Both multivariate models also successfully predicted outcomes. Surgical or follow-up complications were not associated with patients' preoperative status.

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