Personalized Spine Surgery in Adult Deformity: Reoperation Rates and Mechanical Complications Following Customized Planning and Interbody Implant Use
Year: 2025
Type: article
Study design: Observational Study
Abstract: Study Design Retrospective cohort study. Objectives Prior studies have shown that adult spinal deformity (ASD) patients undergoing revision surgery due to mechanical complications had less radiographic improvement and worsening patient-reported outcomes scores. The combination of customized 3D planning and personalized implants has been shown to contribute to improved achievement of alignment goals. This study aimed to determine whether such improved correction also results in a correspondingly lower revision surgery rate due to mechanical complications. Methods Pre- and postoperative radiographic alignment measures, including lumbar lordosis (LL), distal lumbar lordosis (DLL), pelvic incidence (PI) – LL mismatch, and L1 pelvic angle (L1PA), as well as data on mechanical complications leading to reoperation were collected on 115 ASD patients with personalized interbody implants and minimum 2-year follow-up. This cohort was statistically compared to a multicenter dataset (ISSG) of 997 ASD patients treated using stock devices and using the same reoperation classifications. Results Postoperatively achieved alignment measures correlated significantly with their respective preoperative alignment goals, with the following average offsets from plan: 2.4° LL, −0.2° DLL, −2.4° PI-LL, 0.3° L1PA. Compared to the ISSG cohort that utilized stock interbody implants, the cohort utilizing 3D preoperative planning and personalized interbody implants resulted in significantly fewer revisions for mechanical complications up to 2 years postoperatively: 5/115 (4.3%) vs 166/997 (16.6%), P < 0.001. Conclusions These findings suggest that achieving planned alignment targets with personalized interbody devices is associated with reduced revision surgery for mechanical complications, a result which may have positive implications for improved patient outcomes and reduced cost.
Source: Global Spine Journal
Authors: Justin S. Smith, Chun-Po Yen, Roland Kent, Sigurd Berven, Gregory M. Mundis, Robert Robinson, Rodrigo J. Nicolau, Joseph A. Osorio, Jahangir Asghar, J. Rush Fisher, Kelli M. Howell, Mark Tantorski, Donald Blaskiewicz, Jeffrey P. Mullin, Joseph Gjolaj, John Small, Christopher P. Ames
Institutions: University of Virginia, University of California, San Francisco, Scripps Clinic, University of California San Diego, Elite Wellness, University of Pennsylvania Health System, St. Luke’s Boise Medical Center, University at Buffalo, State University of New York, University of Miami Hospital, Florida Orthopaedic Institute
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,650
OpenAlex ID: W4417535228