Long-Term Results of Anterior-Only Lumbar Interbody Fusions in Rheumatoid Arthritis Patients: Comparative Retrospective Cohort Study
| Autor: | Benjamin Thiebaut, Arnaud Dubory, Florent Eymard, Charles Henri Flouzat Lachaniette, Charlie Bouthors, C. Bastard |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Context (language use) Intervertebral Disc Degeneration Arthritis Rheumatoid Cohort Studies Disability Evaluation Postoperative Complications Lumbar medicine Back pain Humans Aged Pain Measurement Retrospective Studies Lumbar Vertebrae business.industry Lumbosacral Region Repeated measures design Retrospective cohort study Middle Aged medicine.disease Confidence interval Surgery Oswestry Disability Index Spinal Fusion Treatment Outcome Rheumatoid arthritis Female Neurology (clinical) medicine.symptom business Follow-Up Studies |
| Zdroj: | World Neurosurgery. 154:e109-e117 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2021.06.128 |
| Popis: | Rheumatoid arthritis (RA) is a risk factor of lumbar spine surgical failure. The interest of anterior lumbar fusion in this context remains unknown. This retrospective study aimed to compare the outcome of anterior-only fusions between RA patients and non-RA (NRA) patients to treat lumbar spine degenerative disorders.NRA and RA groups including anterior-only fusion were compared. Clinical data (Visual Analog Scale score axial back pain scale, the Oswestry Disability Index, and a questionnaire of satisfaction regarding the surgical result); radiologic data (bone fusion, sagittal balance analysis); and adverse events were assessed using repeated measure 1-way analysis of variance.The mean follow-up was 9.5 years (95% confidence interval [7.1-12.2]) for the RA group (n = 13) and 9.4 years (95% confidence interval [8.7-10.3]) for the NRA group (n = 36). Anterior fusion improved clinical outcome without any effect of RA (Visual Analog Scale score axial back pain scale; P0.001/Oswestry Disability Index; P = 0.01). The presence of RA influenced neither the satisfaction as the regards the surgical result nor spine balance nor bone fusion. Context of RA increased the surgical revision rate (10 patients [76.9%] for RA group vs. 3 patients [8.8%] for the NRA group; P = 0.001) because of the occurrence of an adjacent segment disease needing surgical revision (P = 0.028), especially the occurrence of intervertebral frontal dislocation (P = 0.02).As noticed for posterior-only fusion, the anterior lumbar approach in RA patients does not seem to avoid the occurrence of an adjacent segment disease. |
| Databáze: | OpenAIRE |
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