Revision Extension of Fusion Surgery in Thoracolumbar Spine Using a Newly Designed Revision Rod - Comparative Matched Cohort Study Versus Implant-Replacement Surgery.

Abstract

Retrospective cohort study. To compare the results of revision extension of fusion surgery using the newly designed revision rod and implant-replacement surgery in thoracolumbar spine. Thirty-one patients who underwent extension of fusion surgery using the revision rod for adjacent segment disease were included in this study. Thirty-one patients who underwent implant-replacement revision surgery were selected as a control group by matching age, sex, preoperative diagnosis, and number of revision segments. The mean age was 70.7 ± 8.0 years in the revision rod (RR) group and 69.0 ± 8.4 years in the control group. Preoperative diagnoses, underlying diseases, and mean number of revision segments (2.2 ± 1.1) were similar in both groups. The change of hemoglobin (1.0 ± 1.9 vs 2.5 ± 1.5 g/dl; <i>P</i> < .01), hematocrit (4.1 ± 4.9 vs 7.2 ± 4.4 % <i>P</i> < .01) and albumin (.8 ± .9 vs 1.3 ± .4 g/dl; <i>P</i> < .01) levels before and after surgery showed significant differences between the two groups. Hemovac drainage was significantly less in the RR group (<i>P</i> = .01). The mean operative time was shorter in the RR group (203.5 ± 9.5 min vs 233.5 ± 8.7 min; <i>P</i> = .12) with no statistical difference. Radiological results showed that the average lumbar lordosis 2 years after surgery was lower in the RR group compared to the control group (25.1 ± 9.9° vs 32.9 ± 9.8°; <i>P</i> = .02). Union rates and clinical outcomes were not different between the two groups. Revision extension of fusion surgery using a newly designed revision rod had less hemovac drainage and superior laboratory findings compared to implant-replacement revision surgery.