Comparative surgical outcomes of navigated vs non-navigated posterior spinal fusions in ankylosing spondylitis patients

Ankylosing Spondylitis (AS) patients with acute spinal fractures represent a challenge for practicing spine surgeons due to difficult operative anatomy and susceptibility to complications. Does intraoperative CT-navigation improve outcomes in patients with ankylosing spondylitis undergoing surgery?...

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Bibliographic Details
Published in:The surgeon (Edinburgh) 2024-06, Vol.22 (3), p.182-187
Main Authors: Marland, Harry, McDonnell, Jake M., Hughes, Lauren, Morrison, Cronan, Wilson, Kielan V., Cunniffe, Gráinne, Morris, Seamus, Darwish, Stacey, Butler, Joseph S.
Format: Article
Language:English
Subjects:
Acute spinal fractures
Adult
Aged
Ankylosing spondylitis
Female
Fluoroscopy
Humans
Intraoperative navigation
Male
Middle Aged
Post-operative outcomes
Posterior spinal fusion
Retrospective Studies
Spinal Fractures - surgery
Spinal Fusion - methods
Spondylitis, Ankylosing - surgery
Surgery, Computer-Assisted
Tomography, X-Ray Computed
Treatment Outcome
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Summary:Ankylosing Spondylitis (AS) patients with acute spinal fractures represent a challenge for practicing spine surgeons due to difficult operative anatomy and susceptibility to complications. Does intraoperative CT-navigation improve outcomes in patients with ankylosing spondylitis undergoing surgery? A retrospective review was carried out at our centre from 05/2016–06/2021 to identify AS patients presenting with a traumatic spinal fracture, managed surgically with posterior spinal fusion (PSF). Cohorts were categorised and compared for outcomes based on those who underwent PSF with intraoperative CT-navigation versus those surgically managed with traditional intraoperative fluoroscopy. 37 AS patients were identified. 29/37 (78.4%) underwent PSF. Intraoperative navigation was used in 14 (48.3%) cases. Mean age of the entire cohort was 67.6 years. No difference existed between the navigated and non-navigated groups for mean levels fused (5.35 vs 5.07; p ​= ​0.31), length of operation (217.9mins vs 175.3mins; p ​= ​0.07), overall length-of-stay (12 days vs 21.9 days; p ​= ​0.16), patients requiring HDU (3/14 vs 5/15; p ​= ​0.09) or ICU (5/14 vs 9/15; p ​= ​0.10), postoperative neurological improvement (1/14 vs 1/15; p ​= ​0.48) or deterioration (1/14 vs 0/15; p ​= ​0.15), intraoperative complications (2/14 vs 3/15; p ​= ​0.34), postoperative complications 4/14 vs 4/15; p ​= ​0.46), revision surgeries (3/14 vs 1/15; p ​= ​0.16) and 30-day mortality (0/14 vs 0/15). This is the first study that compares surgical outcomes of navigated vs non-navigated PSFs for AS patients with an acute spinal fracture. Although limited by its retrospective design and sample size, this study highlights the non-inferiority of intraoperative navigation as a surgical aid in a challenging cohort. •Patients with ankylosing spondylitis have difficult operative anatomy•Intraoperative CT-navigation may benefit patients with ankylosing spondylitis•Intraoperative CT-navigation has similar outcomes to intraoperative fluoroscopy
ISSN:1479-666X
2405-5840
DOI:10.1016/j.surge.2024.03.002