Adherence to the Lamartina-Berjano Classification and Suggested Surgical Treatment Decreases the Rate of Postoperative Mechanical Failures in Adult Deformity Patients. A Retrospective Observational Study With a Minimum 10 Years Follow-Up.

Abstract

Study DesignRetrospective cohort analysis.ObjectivesTo evaluate the effectiveness of the Lamartina-Berjano (L-B) classification in reducing mechanical complications in patients with adult spinal deformities, with a minimum follow-up of 10 years.MethodsThe study included cases of adult deformity with at least 10 years of follow-up. The rate of clinically-relevant mechanical complications, defined as any implant-related issue requiring revision surgery, was estimated. The independent variable was adherence to the treatment guidelines of the L-B classification. The analysis was limited to patients with thoracolumbar deformities, and the population was stratified according to postoperative alignment using GAP scores.ResultsA total of 121 patients met the inclusion and exclusion criteria. In this cohort, the revision surgery rate for clinically-relevant mechanical complications was 49.6% (60 out of 121 patients). Of these, 90 patients (74%) had surgery following the L-B classification guidelines. A lower risk of complications was observed in aligned patients whose surgeries adhered to the L-B classification. Additionally, the survival curve showed significant differences between patients who followed L-B guidelines and those who did not.ConclusionOur retrospective analysis shows that following the L-B classification guidelines leads to a reduction in mechanical complications in patients with thoracolumbar deformities, particularly in a long-term follow-up scenario.