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Does structural compromise of the aorta in patients with aortic pathologies predict increased spinal and vascular complications and reoperations in patients undergoing anterior approach to the spine?

Shah, Neil V; Çeliker, Pelin; Sadeghi, Cirous; Baum, Rachel; Alam, Juhayer S; Ikwuazom, Chibuokem; Zhou, Peter L; Krasnyanskiy, Benjamin; Kim, David; Desai, Rohan; Bains, Sandeep; Schwartz, Jeffrey M; Diebo, Bassel G; Paulino, Carl B
OBJECTIVES/UNASSIGNED:Anterior spinal fusion (ASF) presents unique challenges, including the proximity of critical anatomic structures. Previous reports have detailed vascular injuries during exposure/approach; however, it is not well-documented whether structural aortic pathology, such as aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors, impacts postoperative outcomes following anterior approach to the spine for spinal fusion. MATERIALS AND METHODS/UNASSIGNED:Using the New York State Statewide Planning and Research Cooperative System, thoracolumbar ASF patients with a history of aneurysm, dissection, atherosclerosis, aortitis, or aortic tumors (APath) were identified and matched to patients with no aortic pathologies (No-APath). The two cohorts were compared at 90-day and 2-year follow-up for complications, readmissions, and revisions. Multivariate binary stepwise logistic regression identified independent predictors of these outcomes. RESULTS/UNASSIGNED:> 0.05). Neither group was observed to require any revisions through 2-year follow-up. The presence of a structural aortic pathology was not associated with increased odds of incurring adverse outcomes at 90-day and 2-year follow-ups. CONCLUSIONS/UNASSIGNED:Structural aortic compromise in the setting of thoracolumbar ASF did not predispose patients to adverse vascular, spinal-related, or medical/surgical complications, nor to anterior spinal or vascular revision or repair through 2-year follow-up. These results highlight the need for well-powered studies to further delineate the risk of anterior spinal surgery in this cohort of patients.
PMCID:11888029
PMID: 40061186
ISSN: 0974-8237
CID: 5808132