World Neurosurg
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Anterior lumbar interbody fusion (ALIF) is a surgical treatment that requires a close operative plane to the great vessels, which increases the risk of perioperative complications. To our knowledge, no previous study has investigated the American Society of Anesthesiologists (ASA) Physical Status Classification System as a predictive factor for unfavorable perioperative outcomes in ALIF procedures. We aimed to analyze the ASA score as a predictive factor of intraoperative and postoperative outcomes in patients undergoing ALIFs. ⋯ Among 210 patients identified, 59 (28.1%) had an ASA score >2 and 151 (71.9%) had an ASA score ≤2. On multivariate analysis, an ASA score >2 was predictive of increased 90-day reoperations (P = 0.02), estimated blood loss (EBL) (P = 0.02), and operative time (P = 0.02). Previous lumbar surgery was predictive of increased length of stay (P = 0.005), EBL (P < 0.001), 90-day readmission (P = 0.02), and operative time (P < 0.001). Posterior supplemental fixation was predictive of increased length of stay (P = 0.04). Increased number of operative levels was predictive of increased EBL (P < 0.001) and operative time (P < 0.001). Perioperative anticoagulation use was predictive of increased EBL (P < 0.001) CONCLUSIONS: Increased ASA scores were associated with unfavorable outcomes after ALIF and also can be used as a predictive tool for the risk of reoperations.
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Osteoporosis is a burgeoning public health problem for over 44 million people in the United States. The magnetic resonance imaging-based vertebral bone quality (VBQ) score and cervical VBQ (C-VBQ) score are two novel approaches that use data routinely gathered during preoperative evaluation to assess bone quality. The goal of this study was to investigate the relationship between the VBQ and C-VBQ scores. ⋯ This is the first study, to our knowledge, to assess the degree to which the newly developed C-VBQ score correlates with the VBQ score. We found a strong positive correlation between the scores.
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Adult thalamic gliomas (ATGs) present a surgical challenge given their depth and proximity to eloquent brain regions. Choosing a surgical approach relies on different clinical variables such as anatomical location and size of the tumor. However, conclusive data regarding how these variables influence the balance between extent of resection and complications are lacking. We aim to systematically review the literature to describe the current surgical outcomes of ATG and to provide tools that may improve the decision-making process. ⋯ Surgical resection of ATGs can increase survival but at the risk of operative morbidity. Knowing which factors impact survival may allow neurosurgeons to propose a more evidence-based treatment to their patients.