Joshua Mathew, Mitchell K Ng, Jonathan Dalton, William Green, Gregorio Baek, Yasmine Eichbaum, Yulia Lee, Morgan Hitchner, Andrew Vanichkachorn, Gil Barksdale, Anthony Buzzetta, Torsten Fras, Dipti Venkatesh, Brandon Martinazzi, Ali Farooqi, Alec Giakas, Paul Mastrokostas, Jeffrey A Rihn, Ian David Kaye, Mark F Kurd, Jose A Canseco, Alan S Hilibrand, Alexander R Vaccaro, Gregory D Schroeder, Christopher K Kepler
In patients with hip-spine syndrome, those treated within 1-year experienced larger improvements in ODI scores and similar 12-month PROMs compared with those treated more than 1-year part. These findings suggest that there may be a benefit to a shorter interval between surgeries in hip-spine syndrome patients, especially in patients with severe hip osteoarthritis.
STUDY DESIGN: Retrospective Cohort Study.
OBJECTIVE: This study aimed to: (1) identify demographic differences based on the interval between surgeries; (2) compare differences in perioperative outcomes; (3) determine whether the interval between hip/spine surgery influences patient-reported outcomes (PROMs).
SUMMARY OF BACKGROUND DATA: The presence of concurrent hip and spine disease in hip-spine syndrome creates a unique challenge in surgical decision-making given overlapping disease, with ideal timing between index spine and hip procedures remaining unclear.
METHODS: A retrospective review was performed at a tertiary care center (2002-2025). Patients were included if they had undergone primary total hip arthroplasty and primary lumbar fusion in any sequence with an available 12-month HOOS score. Patients were divided based on the interval between surgery (<1-year and >1-year). Outcomes included patient reported outcomes (PROMs), number of revision surgeries, and time between procedures. Bivariate comparisons were made using t-tests and chi-square tests as appropriate.
RESULTS: 179 patients (119>1-year, 60<1-year) were included, with no significant differences in demographics. Patients undergoing surgery within 1-year were more likely to have severe hip osteoarthritis and less likely to have mild disease compared to those whose procedures were greater than 1-year apart(P=0.003). There were no differences in revision rates. Order of surgery was associated with interval between procedures (P<0.001). Patients in the <1-year group were more likely to receive spine surgery first (P<0.001), started off with higher baseline ODI (P=0.034), and showed greater improvement after 12 months (P=0.004). HOOS scores improved in both groups, with most patients achieving MCID regardless of surgical interval.
CONCLUSION: In patients with hip-spine syndrome, those treated within 1-year experienced larger improvements in ODI scores and similar 12-month PROMs compared with those treated more than 1-year part. These findings suggest that there may be a benefit to a shorter interval between surgeries in hip-spine syndrome patients, especially in patients with severe hip osteoarthritis.