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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

The CT images and corresponding mode pattern of location relationship between vertebral pedicle screw (total number: 138) and facet joints. No point indicated the vertebral pedicle screw clearly avoids the facet joint, one point indicated the vertebral pedicle screw head is either in contact with or suspected to has invaded the facet joint, and two points indicate the screw has clearly invaded the facet joint
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Fig3: The CT images and corresponding mode pattern of location relationship between vertebral pedicle screw (total number: 138) and facet joints. No point indicated the vertebral pedicle screw clearly avoids the facet joint, one point indicated the vertebral pedicle screw head is either in contact with or suspected to has invaded the facet joint, and two points indicate the screw has clearly invaded the facet joint

Mentions: All the patients were examined postoperatively by lumbar spinal 64-row CT thin layer scanning with 0.5 mm slices. The CT images were assessed by Picture Archiving and Communication Systems. The evaluation standard was according to Seo taxonomy which developed a point system to evaluate the facet joint violations on patients’ CT scan. Specifically, no points were given when the vertebral pedicle screw clearly avoided the facet joint; one point was given when the vertebral pedicle screw head was either in contact with or suspected to have invaded the facet joint; two points were given when the screw had clearly invaded the facet joint (Fig. 3) [21]. The facet violation grade was assessed independently by two surgeons who were blinded to the clinical diseases of patients. If their results are different, the senior author determined the facet violation grade finally. The inter-observer reliability was calculated according to the kappa statistics (kappa coefficient = 0.65). In addition, X-ray examination was also performed to study the facet violation of the patients operatively.Fig. 3


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)

The CT images and corresponding mode pattern of location relationship between vertebral pedicle screw (total number: 138) and facet joints. No point indicated the vertebral pedicle screw clearly avoids the facet joint, one point indicated the vertebral pedicle screw head is either in contact with or suspected to has invaded the facet joint, and two points indicate the screw has clearly invaded the facet joint
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig3: The CT images and corresponding mode pattern of location relationship between vertebral pedicle screw (total number: 138) and facet joints. No point indicated the vertebral pedicle screw clearly avoids the facet joint, one point indicated the vertebral pedicle screw head is either in contact with or suspected to has invaded the facet joint, and two points indicate the screw has clearly invaded the facet joint
Mentions: All the patients were examined postoperatively by lumbar spinal 64-row CT thin layer scanning with 0.5 mm slices. The CT images were assessed by Picture Archiving and Communication Systems. The evaluation standard was according to Seo taxonomy which developed a point system to evaluate the facet joint violations on patients’ CT scan. Specifically, no points were given when the vertebral pedicle screw clearly avoided the facet joint; one point was given when the vertebral pedicle screw head was either in contact with or suspected to have invaded the facet joint; two points were given when the screw had clearly invaded the facet joint (Fig. 3) [21]. The facet violation grade was assessed independently by two surgeons who were blinded to the clinical diseases of patients. If their results are different, the senior author determined the facet violation grade finally. The inter-observer reliability was calculated according to the kappa statistics (kappa coefficient = 0.65). In addition, X-ray examination was also performed to study the facet violation of the patients operatively.Fig. 3

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