Trends in Spinal Deformity Surgery in Marfan Syndrome

ABSTRACT Study Design Analysis of a national database. Objective To analyze trends in fusion surgery for spinal deformity in Marfan Syndrome (MFS) patients, compare patients with and without Marfan, and evaluate differences in surgical approaches. Summary of Background Data National trends of fusion surgery for spinal deformities in MFS patients are not known. Given the rarity of MFS and the nuanced differences in the spinal deformity it causes, it is important to explore differences in fusion surgery between spinal deformity patients with and without MFS. Methods We identified 314 patients (1,410 weighted) with a diagnosis of MFS and spinal deformity who underwent spinal fusion between the years 2003 to 2014. Our primary outcome was national trends in the use of posterior (PSF), anterior-posterior (APSF), and anterior (ASF) spinal fusions. We also compared perioperative complications, mortality rate, length of stay, and hospital charges in a propensity score matched sample of spinal fusion patients with and without a diagnosis of MFS. Results The proportion of PSF surgeries increased significantly (p Conclusions Our study provides findings from the largest sample analyzed to date and is the only thus far that investigates national trends. Our results are largely consistent with those of other works in that MFS patients undergoing spinal fusion surgery have higher neurological complications. We also report that surgical treatment has shifted towards a posterior approach. Our findings can give surgeons a better understanding of the postoperative complications and changing national trends in spinal fusion surgery for patients with MFS.