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NEW YORK, Nov 23, 2020 / PRNewswire / – A new approach to spinal fusion surgery results in reduced blood loss during surgery and less ileus, or intestinal blockage, in the postoperative period, as well as operating times and hospital stays reduced, according to a new study by NYU Langone Health researchers published in The Spine Journal online 13 November.
Spinal fusion, a surgery that connects two or more vertebrae in the spine to treat degenerative or deformity-related spinal conditions such as spinal stenosis, scoliosis, and spondylolisthesis, has traditionally been performed using a technique that involves repositioning the patient, or “flipping” them, in the middle of surgery from the back or side, to the stomach.
This new technique, called single position anterior-posterior lumbar fusion surgery (SPLS), allows surgeons to complete the entire operation while the patient is lying on their side. This allows the surgical team to approach the spine from both the front and back, which leads to a higher fusion rate, minimizing the time required for surgery and allowing for faster recovery.
“This practice-changing technique is not only as safe and effective as the alternatives, but actually offers advantages over the traditional method,” says lead author, Aaron J. Buckland, MD, associate professor in the Department of Orthopedic Surgery at NYU Langone. “With the increased operational efficiency of single position surgery, we are performing less invasive procedures, producing better results and improving safety.”
Researchers examined the perioperative and 90-day outcomes of patients who underwent spinal fusion between May 2012 and June 2019 via a collaboration between NYU Langone Health in New York City and Atlantic neurosurgery and spine specialists in North Carolina. Of the 397 procedures, 153 were classified as a “flip” procedure, meaning the patient was repositioned at least once, and 244 as an SPLS procedure.
Surgeons at NYU Langone’s Spine Center found that SPLS significantly reduced operating time by more than 3 hours, from an average time of 306 minutes to 103 minutes. An associated reduction in blood loss during the operation was also noted, as well as a decrease in intraoperative radiation dosage. The length of hospital stay for patients who received the single position technique was reduced by two days, with an average of approximately four days for patients who received the “flip” procedure compared to less than two days for patients with SPLS.
The SPLS group saw lower rates of postoperative intestinal blockage or ileus. Researchers speculate that this is due to reduced time under anesthesia, more minimally invasive abdominal incisions, reduced need for pain medication, faster mobilization, and patients not lying face down during surgery. . Other complications that can be reduced with the new technique include deep surgical site infection, pressure areas, peripheral nerve injuries, and airway access difficulties.
According to Themistocles Protopsaltis, MD, associate professor in the Departments of Orthopedic Surgery and Neurosurgery and Head of the Division of Spine Surgery at NYU Langone, and co-author of the study, “This research exemplifies our division’s mission of spinal surgery to bring techniques to cutting edge for patients while improving clinical outcomes. ”
Researchers in this retrospective review are opening a prospective multicenter study to evaluate SLPS against minimally invasive posterior fusion and to further validate its efficacy.
In addition to Drs. Buckland and Protopsaltis, other NYU Langone researchers are Kimberly Ashayeri, MD, and Leon Eisen, MD. Atlantic Neurosurgical and Spine Specialists co-authors include J. Alex Thomas, MD, and Mark Medley, MD.
Media inquiries:
Annie Harris
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SOURCE NYU Langone Health
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