Volume 12, Issue 1 (Winter 2025)
JROS 2025, 12(1): 57-64 |
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Chehrassan M, Nikouei F, Shakeri M, Azarnia G, Ahmadi R, Ghavidel E, et al . Complications and Radiological Findings in One-stage Versus Two-stage Revision Surgery for Complex Degenerative Spinal Deformities. JROS 2025; 12 (1) :57-64
URL: http://jros.iums.ac.ir/article-1-2291-en.html
URL: http://jros.iums.ac.ir/article-1-2291-en.html
Mohammadreza Chehrassan1 
, Farshad Nikouei1 , Mohammadreza Shakeri1 , Gholamreza Azarnia2 , Reza Ahmadi2 , Ehsan Ghavidel1 , Ebrahim Ameri Mahabadi1 , Hasan Ghandhari1
, Farshad Nikouei1 , Mohammadreza Shakeri1 , Gholamreza Azarnia2 , Reza Ahmadi2 , Ehsan Ghavidel1 , Ebrahim Ameri Mahabadi1 , Hasan Ghandhari1
1- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. & Department of Orthopedics Surgery, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Department of Orthopedics, Bone and Joint Reconstruction Research Center, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. & Department of Orthopedics Surgery, Shafayahyaeian Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abstract: (212 Views)
Background: Revision long-segment posterior spinal fusion (PSF) for complex degenerative spinal deformity is technically demanding and associated with significant perioperative risks. Whether a one-stage or two-stage strategy yields superior outcomes remains controversial. Objectives: In this study, we aimed to compare radiologic outcomes, perioperative parameters, and complication rates between one-stage and two-stage revision of long-segment PSF.
Methods: We retrospectively reviewed 45 patients who underwent revision long-segment PSF at our tertiary center between 2021 and 2023. Patients were divided into one-stage (n=29) and two-stage (n=16) groups. Demographic, perioperative, and imaging parameters, as well as complication rates, were compared between groups.
Results: Both groups demonstrated significant improvement in sagittal and coronal alignment, with no statistically significant differences in radiologic outcomes. Operative time (P=0.038) and hemoglobin drop (P=0.001) were significantly greater in the two-stage group. Hospital stay tended to be longer in staged procedures, though the difference was not statistically significant. Overall complication rates were comparable between the groups (48.3% vs 37.5%, P=0.544), with infection being the most common complication in both groups (17.2% vs 18.7%).
Conclusion: One-stage and two-stage revision long-segment PSF achieved comparable radiologic outcomes and complication rates. However, the one-stage approach was associated with shorter operative time and reduced hemoglobin drop. These findings suggest that single-stage revision surgery may provide favorable perioperative outcomes without compromising safety.
Methods: We retrospectively reviewed 45 patients who underwent revision long-segment PSF at our tertiary center between 2021 and 2023. Patients were divided into one-stage (n=29) and two-stage (n=16) groups. Demographic, perioperative, and imaging parameters, as well as complication rates, were compared between groups.
Results: Both groups demonstrated significant improvement in sagittal and coronal alignment, with no statistically significant differences in radiologic outcomes. Operative time (P=0.038) and hemoglobin drop (P=0.001) were significantly greater in the two-stage group. Hospital stay tended to be longer in staged procedures, though the difference was not statistically significant. Overall complication rates were comparable between the groups (48.3% vs 37.5%, P=0.544), with infection being the most common complication in both groups (17.2% vs 18.7%).
Conclusion: One-stage and two-stage revision long-segment PSF achieved comparable radiologic outcomes and complication rates. However, the one-stage approach was associated with shorter operative time and reduced hemoglobin drop. These findings suggest that single-stage revision surgery may provide favorable perioperative outcomes without compromising safety.
Keywords: Revision surgery, Long-segment, Posterior spinal fusion (PSF), Spinal deformity, One stage, Two stage, Complications, Outcomes
Type of Study: Research Article |
Subject:
Spine surgery
Received: 2024/06/22 | Accepted: 2024/11/23 | Published: 2025/02/1
Received: 2024/06/22 | Accepted: 2024/11/23 | Published: 2025/02/1
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