Abstract
BACKGROUND CONTEXT Recently, multilevel lateral interbody fusion (LIF) has been used for the surgical treatment for adult spinal deformity (ASD). Despite the favorable clinical and radiographic outcomes in the previous literatures, the utility and cost effectiveness of LIF in conjunction with posterior spinal fusion (PSF) is still controversial. PURPOSE The purposes of this study were to compare the utility and cost effectiveness of multilevel LIF with PSF (L group) and PSF with TLIF (P group) in ASD surgery. STUDY DESIGN/SETTING Retrospective case series PATIENT SAMPLE Surgically treated 88 ASD patients (L group [n=39, mean age 69yrs] and P group [n=49, mean age 68yrs]) were identified retrospectively from multicenter database. OUTCOME MEASURES Demographic and radiographic data, health-related quality of life (HRQoL), and the direct hospitalization cost for the initial surgery and 2y total in hospitalization cost were analyzed. METHODS All patients were followed for minimum of 2yrs. The variables were collected from medical charts and retrospectively assessed. The student t-test, Mann-Whitney U-test and Chi-square test were used to statistically analyze the data. RESULTS Analyses of sagittal spinal alignment showed no significant difference between 2 groups at baseline and 2y post-op (P vs L: baseline C7SVA; 11cm vs 10 cm, p=0.71, PT; 33° vs 37°, p=0.10, PI-LL; 38° vs 37°, p=0.88, 2y post-op: C7SVA; 4cm vs 4 cm, p=0.74, PT; 23° vs 27°, p=0.06, PI-LL 6° vs 6°, p=0.97). Surgical time and blood loss were significantly higher in P group (P vs L: 268 vs 354 min, p CONCLUSIONS LIF with PSF is a similarly effective surgery for ASD when compared with the conventional PSF. However, due to the significantly higher cost, additional studies on the cost effectiveness of LIF in different ASD patient cohort are warranted. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.
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