• Samuel S Rudisill, Dustin H Massel, Alexander L Hornung, Cameron Kia, Karan Patel, Khaled Aboushaala, Mbagwu Chukwuemeka, WongArnold Y LAYLThe International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, USA.Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hong Kong SAR, China., J Nicolas Barajas, G Michael Mallow, Sheila J Toro, Harmanjeet Singh, Rahul Gawri, Philip K Louie, Frank M Phillips, Howard S An, and Dino Samartzis.
• Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA.
• Eur Spine J. 2025 Jan 1; 34 (1): 170181170-181.

PurposeThis study aimed to explore associations between ABO blood type and postoperative adjacent segment degeneration/disease (ASD) following lumbar spine fusion, as well as evaluate differences in spinopelvic alignment, perioperative care, postoperative complications, and patient-reported outcome measures (PROMs).MethodsAn ambispective study was performed. Patients who underwent posterolateral or posterior lumbar interbody fusion were included. Demographic, perioperative and postoperative, clinical, and blood type information was recorded. Pre- and post-operative radiographic imaging was analyzed for alignment parameters and development of ASD.Results445 patients were included, representing O+ (36.0%), O- (5.2%), A+ (36.2%), A- (6.3%), B+ (12.1%), B- (1.6%), and AB+ (2.7%) blood types. Most patients were female (59.1%), and had a mean age of 60.3 years and BMI of 31.1 kg/m2. Postoperatively, groups did not differ in duration of the hospital (p = 0.732) or intensive care unit (p = 0.830) stay, discharge disposition (p = 0.504), reoperation rate (p = 0.192), or in-hospital complication rate (p = 0.377). Postoperative epidural hematoma was most common amongst A + patients (p = 0.024). Over a mean of 11.0 months of follow-up, all patients exhibited similar improvement in PROMs, with 132 (29.7%) patients developing radiographic evidence of ASD. B + patients were significantly more likely than A + and O + patients to develop spondylolisthesis and ASD (p < 0.05). No significant differences in sagittal alignment parameters and number of levels of fusion were found (p > 0.05).ConclusionsThis is the first large-scale study to address and demonstrate proof-of-principle that ABO blood type, a non-modifiable risk factor, is associated with ASD following lumbar spine fusion.© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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