医学
骨不连
Oswestry残疾指数
优势比
脊柱融合术
外科
可能性
腰椎
背痛
回顾性队列研究
逻辑回归
腰痛
内科学
病理
替代医学
作者
Taryn E. LeRoy,Isabel C. Smith,David H. Kim,Samuel W. Golenbock,Kevin C. Baker,Paul M. Arnold,Rick C. Sasso,Daniel K. Park,Jeffrey S. Fischgrund,Qasim Hassan Zaidi,Raymond Hwang
出处
期刊:Clinical spine surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2023-02-22
卷期号:36 (6): E258-E262
被引量:2
标识
DOI:10.1097/bsd.0000000000001440
摘要
Retrospective cohort study.Our objective was to determine whether lateral pedicle screw breach affects fusion rates and patient-reported outcomes in lumbar fusion surgery.Although lateral pedicle screw malposition is considered relatively benign, few studies have focused specifically on clinical outcomes or fusion rates associated with lateral screw malposition.Twelve-month postoperative computed tomography scans were reviewed for lateral breach, severity of breach, and fusion status. Patients with lateral breach were compared with patients with no breach. Outcome measures included Numerical Pain Rating Scale for back and leg pain, Oswestry Disability Index, and SF-36 physical function (SF-36 PF). Multivariable linear and logistic regression and were adjusted for age, procedure, level, and/or baseline pain score.Forty-five patients (31%) demonstrated 1 or more lateral breaches as compared with 99 patients without breach. After adjusting for baseline scores and fusion level, patients with 2 or more screw breaches experienced SF-36 PF score improvements that were 3.43 points less ( P =0.016) than patients with no lateral breach. After adjusting for baseline Numerical Pain Rating Scale, there was also a significant decrease in the odds of achieving minimally clinical important difference in back pain relief in these patients. There was no observed effect of lateral breach on the odds of successful fusion.The current study did not observe an association between laterally malpositioned pedicle screws and nonunion. However, results are consistent with a negative effect on SF-36 PF scores and self-reported back pain at 12 months.
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