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Spine Rapid Fire Abstract

Spine

Analyzing the Impact of Anesthesia Duration, Fusion Levels, and Estimated Blood Loss on Early Ambulation After Spinal Fusion Surgery for Adult Degenerative Scoliosis: A Multivariate Approach

Saturday, May 4, 2024
4:25 PM – 4:27 PM CT
Location:  S403ab
Disclosure(s):
Michael Farid, BSE: No financial relationships to disclose
Introduction: Adult degenerative scoliosis (ADS) is a heterogeneous condition commonly treated with spinal fusion. The time to initiate walking postoperatively is a key indicator of patient recovery and is influenced by multiple intraoperative factors. While levels of fusion have been previously considered as a determinant of early ambulation, their impact relative to other potentially linked factors such as estimated blood loss (EBL) and anesthesia duration has not been fully elucidated, and was the goal of this study.

Methods: All ADS patients who underwent long-segment thoracolumbar fusion for abnormal spinal curvature from 2016-2020 were included. Patient data was retrospectively analyzed to investigate the influence of levels of fusion on walking initiation postoperatively through linear regression analysis. Multivariate regression was performed to control for factors such as age, gender, comorbidities, preoperative disability, and lifestyle indicators.

Results: In our cohort of 235 patients, the mean levels fused was 9.32±2.79 and mean postoperative days before walking was 2.25±2.73. Univariate regression revealed a strong influence of the levels of fusion on walking initiation, with each level of fusion corresponding on average to 0.18 days increase in postoperative days before walking (p < 0.01), but this relationship was not evident in the multivariate regression analysis. However, when controlling for the comprehensive set of variables, multivariate regression showed that only anesthesia duration remained a significant predictor of delayed walking initiation (β=0.0178, p< 0.001), while the impact of EBL (β=0.0003, p=0.231) and levels of fusion (β=0.029, p=0.782) was not significant.

Conclusion : The discrepancy between univariate and multivariate findings highlights the necessity of a multifaceted analytical approach. Anesthesia duration emerged as a critical, modifiable predictor of early ambulation, independent of the levels of fusion or EBL when controlling for a comprehensive set of clinical and demographic factors. These insights highlight the importance of optimizing anesthesia protocols to enhance recovery and encourage earlier walking postoperatively.