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Introduction <p>Adult Spinal Deformity (ASD) involves age-related lumbar degeneration and curvature. Treatment begins with therapy and pain management, but severe cases may need surgery. This study examines the impact of adjunctive spinal surgeries with fusion on surgical outcomes.</p> Methods <p>This study reviewed ASD patients undergoing long-segment thoracolumbar fusion. Patients were classified as fusion-only or adjunctive (laminectomy plus fusion). Propensity score matching (PSM) adjusted for cohort parameters. Primary outcomes were analyzed across four domains: blood loss, functional recovery, hospital length of stay (LOS) and operative complications using standardized treatment effects.</p> Results <p>After PSM (Adjunctive, <i>n</i> = 82; Fusion-only, <i>n</i> = 34), no significant differences were observed in anesthesia duration, blood loss metrics, transfusion volumes, or postoperative Oswestry Disability Index improvements between groups. However, adjunctive surgery was associated with delayed postoperative initiation of walking (mean difference: 0.66 days, 95%CI: 0.19–1.14; <i>p</i> = 0.006) and reduced risk of hardware failure (RD: -0.11, 95%CI: -0.23, -0.0; <i>p</i> = 0.047). No differences were found in rates of infections, pseudarthrosis or overall complication.</p> Conclusion <p>Adjunctive spine surgery showed delayed post-operative ambulation and reduced risk for hardware failure. However, functional improvement, overall complication rates and blood loss metrics were largely comparable. These findings suggest that adjunctive procedures may be safely performed when clinically indicated but should be selectively applied based on individual patient characteristics risk profiles and goals of surgery.</p>

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Impact of adjunctive spine surgery on multilevel spinal fusion in the management of adult spinal deformity: A single centre propensity score-matched analysis

  • 期刊论文

  • 发表日期：

    2026年2月13日

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  • Kwadwo Darko,
  • Sruja Arya,
  • Bernice Limann,
  • Prince Agyapong,
  • Joseph Zakaria,
  • Mina Guirgius,
  • Pooja Venkatesh,
  • Bradley Guidry,
  • Omar Akbik,
  • Kristen Hall,
  • Umaru Barrie,
  • Salah Aoun,
  • Carlos Bagley

摘要

Introduction

Adult Spinal Deformity (ASD) involves age-related lumbar degeneration and curvature. Treatment begins with therapy and pain management, but severe cases may need surgery. This study examines the impact of adjunctive spinal surgeries with fusion on surgical outcomes.

Methods

This study reviewed ASD patients undergoing long-segment thoracolumbar fusion. Patients were classified as fusion-only or adjunctive (laminectomy plus fusion). Propensity score matching (PSM) adjusted for cohort parameters. Primary outcomes were analyzed across four domains: blood loss, functional recovery, hospital length of stay (LOS) and operative complications using standardized treatment effects.

Results

After PSM (Adjunctive, n = 82; Fusion-only, n = 34), no significant differences were observed in anesthesia duration, blood loss metrics, transfusion volumes, or postoperative Oswestry Disability Index improvements between groups. However, adjunctive surgery was associated with delayed postoperative initiation of walking (mean difference: 0.66 days, 95%CI: 0.19–1.14; p = 0.006) and reduced risk of hardware failure (RD: -0.11, 95%CI: -0.23, -0.0; p = 0.047). No differences were found in rates of infections, pseudarthrosis or overall complication.

Conclusion

Adjunctive spine surgery showed delayed post-operative ambulation and reduced risk for hardware failure. However, functional improvement, overall complication rates and blood loss metrics were largely comparable. These findings suggest that adjunctive procedures may be safely performed when clinically indicated but should be selectively applied based on individual patient characteristics risk profiles and goals of surgery.