TY - JOUR
T1 - Comparison of Overall Complication Rates in VCR-Based vs Non-VCR-Based Corrective Techniques in Severe Rigid Kyphoscoliosis Patients
T2 - A Systematic Review and Meta-Analysis
AU - Van Halm-Lutterodt, Nicholas Ishmael
AU - Al-Saidi, Neil Nazar
AU - Mandalia, Krishna
AU - Mesregah, Mohamed Kamal
AU - Ghanem, Kristina Marie
AU - Storlie, Nicholas Robert
AU - Huang, Wei Hsun
AU - Chen, Wei Cheng
AU - Bartels-Mensah, Mercy
AU - Chen, Xin Yuan
AU - Ye, Ziyang
AU - Zhang, Yangpu
AU - Pan, Aixing
AU - Kim, Sunny Sik
AU - Lonner, Baron
AU - Alanay, Ahmet
AU - Hai, Yong
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2023/7
Y1 - 2023/7
N2 - Study Design: Systematic review and meta-analysis. Objective: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes between those classified osteotomy approaches. Methods: Thorough literature review and meta-analysis were conducted between January 2000 and September 2021. The selection criteria were studies: i) reporting major curve Cobb angle of ≥80° and flexibility of <25% or 30%; ii) comparing VCR or ≥ Type V Schwab osteotomy defined as VCR-based vs [non-VCR-based] techniques, (any osteotomy or technique other than VCR); iii) published in English with ≥10 patients; iv) reporting complication rates; and v) having minimum of 2-year follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Significance level was set at (P <.05). Results: Of the 174 patients included, 52.30% (n = 91) and 47.70% (n = 83) were VCR-based and non-VCR-based, respectively. The incidence of dural tears/nerve injuries/significant intraoperative-neuromonitoring changes was significantly higher; [OR = 6.78, CI= (1.75 to 26.17), I2 = 0%, (P =.006)] in the VCR-based group than the non-VCR-based group. The ‘overall surgical and medical’ complication rate was significantly higher in the VCR-based group, [OR = 1.94, CI= (1.02 to 3.67), I2 = 31%, (P =.04)]. Conclusion: Both VCR-based and non-VCR-based surgical techniques for management of severe rigid scoliosis and kyphoscoliosis patients pose comparable overall surgical complication rates, while a significantly higher perioperative neurological complication incidence was associated with VCR-based technique compared to the non-VCR-based techniques. The VCR-based technique was associated with 6.78 times higher incidence of neurological complications compared to non-VCR-based techniques.
AB - Study Design: Systematic review and meta-analysis. Objective: Compilation of complication outcomes data from the surgical management of severe rigid kyphoscoliosis patients using VCR-based vs non-VCR-based corrective maneuvers is lacking. This meta-analysis aimed to compare complication outcomes between those classified osteotomy approaches. Methods: Thorough literature review and meta-analysis were conducted between January 2000 and September 2021. The selection criteria were studies: i) reporting major curve Cobb angle of ≥80° and flexibility of <25% or 30%; ii) comparing VCR or ≥ Type V Schwab osteotomy defined as VCR-based vs [non-VCR-based] techniques, (any osteotomy or technique other than VCR); iii) published in English with ≥10 patients; iv) reporting complication rates; and v) having minimum of 2-year follow-up. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Significance level was set at (P <.05). Results: Of the 174 patients included, 52.30% (n = 91) and 47.70% (n = 83) were VCR-based and non-VCR-based, respectively. The incidence of dural tears/nerve injuries/significant intraoperative-neuromonitoring changes was significantly higher; [OR = 6.78, CI= (1.75 to 26.17), I2 = 0%, (P =.006)] in the VCR-based group than the non-VCR-based group. The ‘overall surgical and medical’ complication rate was significantly higher in the VCR-based group, [OR = 1.94, CI= (1.02 to 3.67), I2 = 31%, (P =.04)]. Conclusion: Both VCR-based and non-VCR-based surgical techniques for management of severe rigid scoliosis and kyphoscoliosis patients pose comparable overall surgical complication rates, while a significantly higher perioperative neurological complication incidence was associated with VCR-based technique compared to the non-VCR-based techniques. The VCR-based technique was associated with 6.78 times higher incidence of neurological complications compared to non-VCR-based techniques.
KW - comparative studies
KW - kyphoscoliosis
KW - neurological complications
KW - perioperative complications
KW - severe rigid scoliosis
KW - vertebral column resection surgery
UR - http://www.scopus.com/inward/record.url?scp=85145507016&partnerID=8YFLogxK
U2 - 10.1177/21925682221146502
DO - 10.1177/21925682221146502
M3 - Review article
AN - SCOPUS:85145507016
SN - 2192-5682
VL - 13
SP - 1646
EP - 1657
JO - Global Spine Journal
JF - Global Spine Journal
IS - 6
ER -