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Analysis of risk factors for adjacent superior vertebral pedicle-induced facet joint violation during the minimally invasive surgery transforaminal lumbar interbody fusion: a retrospective study.

Zeng ZL, Jia L, Xu W, Yu Y, Hu X, Jia YW, Wang JJ, Cheng LM - Eur. J. Med. Res. (2015)

Bottom Line: No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations.Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227-6.864; P = 0.015) and BMI ≥30 kg/m(2) (OR: 2.825; 95 % CI 1.191-6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation.These results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai, China. zzl995766@sina.com.

ABSTRACT

Background: The purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF).

Methods: A total of 69 patients with lumbar degenerative disease, who underwent MIS-TLIF were retrospectively reviewed. Postoperative computed tomography images were used to assess the facet joint violation. The correlation of facet joint violations with gender, age, body mass index (BMI), the adjacent superior vertebral level, fusion segment numbers, position of screw insertion, straight leg-raising test (SLRT) results, clinical diseases and renal dysfunction were analyzed by Chi-square tests and binary logistic regression analysis.

Results: The incidence of adjacent superior facet joint violations was 25.4 %. Chi-square test showed the patients with age <60 and high BMI (≥30 kg/m(2)) were more prone to have facet joint violations (P = 0.007; P = 0.006). The single segment fusion presented more facet joint violations than the double segments fusion (P = 0.048). The vertebral pedicle screw implant location at L5 showed more facet joint violations compared with that at L3 and L4 (P = 0.035). No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations. Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227-6.864; P = 0.015) and BMI ≥30 kg/m(2) (OR: 2.825; 95 % CI 1.191-6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation.

Conclusion: These results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF. Age <60 and BMI ≥30 kg/m(2) might be risk factors of facet joint violation. Evidence level: Level 4.

No MeSH data available.


Related in: MedlinePlus

Flow chart of patients’ selection
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Fig1: Flow chart of patients’ selection

Mentions: From December, 2012 to June, 2014, 95 consecutive patients with lumbar degenerative disease (male, 35; female, 34; average age: 54.8 ± 4.8 years) who underwent minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) were retrospectively reviewed in this study (approved by Tongji Hospital, Tongji University School of Medicine). The surgical indications were patients who had clear lumbocrural pain or fall bilge feeling and invalid improvements after at least 3 months of conservative treatment. Of the 95 patients, 73 patients met the inclusion criteria: patients suffered from lumbar degenerative disease with lumbar disc herniation or lumbar spinal stenosis or lumbar spondylolisthesis or endplate Modic changes [20]. These diseases were confirmed by preoperative computed tomography (CT) and magnetic resonance imaging (MRI). The exclusion criteria were as follows: presence of obvious pedicle screw position deviation or even needing a second revision surgery because of non-standard surgical manipulation; degenerative lumbar scoliosis; spinal tumor. Then, 4 patients were excluded. Finally, 69 patients were included in the study with complete medical records and follow-up data (Fig. 1). Among the patients, 45 patients were with hip or unilateral lower limb radiation pain, 20 patients were with bilateral lower limb radiation pain, 25 patients were with positive results of straight leg-raising test (SLRT) and strengthen test, and 3 patients were with urine dysfunction.Fig. 1


Analysis of risk factors for adjacent superior vertebral pedicle-induced facet joint violation during the minimally invasive surgery transforaminal lumbar interbody fusion: a retrospective study.

Zeng ZL, Jia L, Xu W, Yu Y, Hu X, Jia YW, Wang JJ, Cheng LM - Eur. J. Med. Res. (2015)

Flow chart of patients’ selection
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4581410&req=5

Fig1: Flow chart of patients’ selection
Mentions: From December, 2012 to June, 2014, 95 consecutive patients with lumbar degenerative disease (male, 35; female, 34; average age: 54.8 ± 4.8 years) who underwent minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) were retrospectively reviewed in this study (approved by Tongji Hospital, Tongji University School of Medicine). The surgical indications were patients who had clear lumbocrural pain or fall bilge feeling and invalid improvements after at least 3 months of conservative treatment. Of the 95 patients, 73 patients met the inclusion criteria: patients suffered from lumbar degenerative disease with lumbar disc herniation or lumbar spinal stenosis or lumbar spondylolisthesis or endplate Modic changes [20]. These diseases were confirmed by preoperative computed tomography (CT) and magnetic resonance imaging (MRI). The exclusion criteria were as follows: presence of obvious pedicle screw position deviation or even needing a second revision surgery because of non-standard surgical manipulation; degenerative lumbar scoliosis; spinal tumor. Then, 4 patients were excluded. Finally, 69 patients were included in the study with complete medical records and follow-up data (Fig. 1). Among the patients, 45 patients were with hip or unilateral lower limb radiation pain, 20 patients were with bilateral lower limb radiation pain, 25 patients were with positive results of straight leg-raising test (SLRT) and strengthen test, and 3 patients were with urine dysfunction.Fig. 1

Bottom Line: No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations.Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227-6.864; P = 0.015) and BMI ≥30 kg/m(2) (OR: 2.825; 95 % CI 1.191-6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation.These results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF.

View Article: PubMed Central - PubMed

Affiliation: Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, 389 Xincun Road, Shanghai, China. zzl995766@sina.com.

ABSTRACT

Background: The purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF).

Methods: A total of 69 patients with lumbar degenerative disease, who underwent MIS-TLIF were retrospectively reviewed. Postoperative computed tomography images were used to assess the facet joint violation. The correlation of facet joint violations with gender, age, body mass index (BMI), the adjacent superior vertebral level, fusion segment numbers, position of screw insertion, straight leg-raising test (SLRT) results, clinical diseases and renal dysfunction were analyzed by Chi-square tests and binary logistic regression analysis.

Results: The incidence of adjacent superior facet joint violations was 25.4 %. Chi-square test showed the patients with age <60 and high BMI (≥30 kg/m(2)) were more prone to have facet joint violations (P = 0.007; P = 0.006). The single segment fusion presented more facet joint violations than the double segments fusion (P = 0.048). The vertebral pedicle screw implant location at L5 showed more facet joint violations compared with that at L3 and L4 (P = 0.035). No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations. Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227-6.864; P = 0.015) and BMI ≥30 kg/m(2) (OR: 2.825; 95 % CI 1.191-6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation.

Conclusion: These results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF. Age <60 and BMI ≥30 kg/m(2) might be risk factors of facet joint violation. Evidence level: Level 4.

No MeSH data available.


Related in: MedlinePlus