Accepted for/Published in: Interactive Journal of Medical Research
Date Submitted: Oct 7, 2024
Open Peer Review Period: Oct 9, 2024 - Nov 5, 2024
Date Accepted: Jan 7, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Staging in Circumferential Spinal Fusion for Adult Spinal Deformity: Systematic Review and Meta-Analysis
ABSTRACT
Background:
Adult spinal deformity (ASD) is a prevalent condition often treated with circumferential spinal fusion (CF), which can be performed as Staged or Same-Day procedures. However, evidence guiding the choice between these approaches is lacking.
Objective:
This systematic review and meta-analysis aimed to evaluate patient outcomes following Staged and Same-Day CF for ASD.
Methods:
Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive literature search was conducted in major databases. Eligible studies comparing Staged and Same-Day CF in adults with ASD were included. Data were extracted, and meta-analysis was performed for peri-operative outcomes and adverse events.
Results:
Following exclusion criteria, seven studies were included for review. A total of 741 patients undergoing CF for ASD were included in the review (Staged: 331; Same-Day: 410). Four studies that had comparable outcomes were merged for the quantitative meta-analysis and split based on observed measures. Meta-analysis revealed significantly shorter operative time and hospital length of stay for Same-Day CF. Estimated blood loss and peri-operative adverse events trended towards significance favoring Same-Day CF. However, intra-operative and post-operative adverse event, reoperation, and readmission rates showed inconsistent findings between studies. Data quality assessment revealed a moderate degree of bias for all included studies.
Conclusions:
Same-Day CF may offer advantages in terms of shorter operative time and hospital stay compared to Staged CF for ASD. However, there was marked heterogeneity in peri-operative outcomes reporting, and continuous variables were inconsistently presented. This underscored the need for standardized reporting of clinical variables and patient reported outcomes and higher evidence randomized controlled trials to elucidate the clinical superiority of either approach. Clinical Trial: In accordance with PRISMA-P guidelines, the protocol of the systematic review was registered on the International Prospective Register of Ongoing Systematic Reviews (PROSPERO) (CRD42022339764) and disseminated through the Journal of Medical Internet Research (JMIR) Research Protocols (International Registered Report Identifier (IRRID): PRR1-10.2196/4233)
Citation
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Copyright
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