Supplementary posterior fusion in patients operated on employing TLIF may decrease the instrumentation failure rate

Autor: Andrey Bokov, Svetlana Kalinina, Mingiyan Khaltyrov, Svetlana Pavlova, Anatoliy Bulkin
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Frontiers in Surgery, Vol 10 (2023)
Druh dokumentu: article
ISSN: 2296-875X
DOI: 10.3389/fsurg.2023.1259946
Popis: BackgroundIt is supposed that additional posterior fusion may provide additional stability of the pedicle screw; however, the clinical impact of additional posterior fusion in patients treated with TLIF remains uncertain. The objective of this study is to assess the clinical efficacy of circumferential fusion in patients treated with TLIF.Materials and methodsThis is a single-center retrospective evaluation of consecutive 179 patients with degenerative lumbar stenosis and instability of spinal segments. Patients with axial pain and neurogenic claudication or radiculopathy associated with spinal stenosis were enrolled during the period from 2012 to 2018. Transforaminal lumbar interbody fusion (TLIF) with a single cage was used to treat patients. In 118 cases a supplementary posterior fusion was made. The duration of follow-up accounted for 24 months, logistic regression analysis was used to assess factors that influence the complication rate.ResultsThe rate of pedicle screw loosening was growing with radiodensity getting decreased and was more frequent in patients with two level fusion. An increase in pedicle screw loosening rate correlated with anterior nonunion Tan 2 and 3 grade while both posterior complete and incomplete fusion resulted in a decline in the complication rate. Lumbosacral fusion, bilateral facet joints` resection and laminectomy turned out to be insignificant factors. The overall goodness of fit of the estimated general multivariate model was χ2 = 87.2230; P
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