Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study

Abstract Study design A retrospective cohort study. Objective To investigate the radiological and clinical outcomes of patients with or without pedicle-screw rod fixation (PSRF) in OLIF surgery. Methods Between June 2017 and December 2019, 66 consecutive patients who underwent OLIF surgery at two ce...

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Main Authors: Kaiwen Cai, Kefeng Luo, Jinjin Zhu, Kai Zhang, Shengkai Yu, Yi Ye, Guoqiang Jiang
Format: Article
Language:English
Published: BMC 2021-07-01
Series:Journal of Orthopaedic Surgery and Research
Online Access:https://doi.org/10.1186/s13018-021-02570-8
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author Kaiwen Cai
Kefeng Luo
Jinjin Zhu
Kai Zhang
Shengkai Yu
Yi Ye
Guoqiang Jiang
author_facet Kaiwen Cai
Kefeng Luo
Jinjin Zhu
Kai Zhang
Shengkai Yu
Yi Ye
Guoqiang Jiang
author_sort Kaiwen Cai
collection DOAJ
description Abstract Study design A retrospective cohort study. Objective To investigate the radiological and clinical outcomes of patients with or without pedicle-screw rod fixation (PSRF) in OLIF surgery. Methods Between June 2017 and December 2019, 66 consecutive patients who underwent OLIF surgery at two centers were divided into stand-alone and combined groups according to whether or not PSRF was used. Imaging and clinical data were collected preoperatively, postoperatively, 3 and 6 months postoperatively, and at the last follow-up. Related coefficient and multiple linear regression analysis was used to detect the influencing factors of cage subsidence (CS). Results There was a lower baseline BMD in the combined group (p = 0.005). The combined group showed superior VAS score at 3 months postoperatively, although there was no difference in long-term VAS and ODI scores between the two groups. The foraminal height (FH) of the two groups was comparable at preoperatively, postoperatively, and 3 months postoperatively, but the combined group showed better maintenance of FH at 6 months postoperatively (p = 0.049) and last follow-up (p = 0.019). The total CS (tCS) of the combined group was lower than that of the stand-alone group during the whole follow-up period (all p ≤ 0.001). Multiple linear regression suggested that lower BMD was the risk factor for main CS, and PSRF could significantly reduce the BMD threshold for severe CS (−4.77 vs −1.38). Conclusions OLIF combined with PSRF can effectively avoid foraminal height loss and prevent severe CS, which may be more suitable for patients with osteoporosis or osteopenia and improve clinical outcomes.
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spelling doaj.art-3eb927315140417ba3065729298dcca02022-12-22T04:21:15ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-07-011611810.1186/s13018-021-02570-8Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort studyKaiwen Cai0Kefeng Luo1Jinjin Zhu2Kai Zhang3Shengkai Yu4Yi Ye5Guoqiang Jiang6Department of Orthopaedic, The Affiliated Hospital of Medical School of Ningbo UniversityDepartment of Orthopaedic, The Affiliated Hospital of Medical School of Ningbo UniversityDepartment of Orthopaedic, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityDepartment of Orthopaedic, The Affiliated Hospital of Medical School of Ningbo UniversityThe Medical School of Ningbo UniversityDepartment of Orthopaedic, The Affiliated Hospital of Medical School of Ningbo UniversityDepartment of Orthopaedic, The Affiliated Hospital of Medical School of Ningbo UniversityAbstract Study design A retrospective cohort study. Objective To investigate the radiological and clinical outcomes of patients with or without pedicle-screw rod fixation (PSRF) in OLIF surgery. Methods Between June 2017 and December 2019, 66 consecutive patients who underwent OLIF surgery at two centers were divided into stand-alone and combined groups according to whether or not PSRF was used. Imaging and clinical data were collected preoperatively, postoperatively, 3 and 6 months postoperatively, and at the last follow-up. Related coefficient and multiple linear regression analysis was used to detect the influencing factors of cage subsidence (CS). Results There was a lower baseline BMD in the combined group (p = 0.005). The combined group showed superior VAS score at 3 months postoperatively, although there was no difference in long-term VAS and ODI scores between the two groups. The foraminal height (FH) of the two groups was comparable at preoperatively, postoperatively, and 3 months postoperatively, but the combined group showed better maintenance of FH at 6 months postoperatively (p = 0.049) and last follow-up (p = 0.019). The total CS (tCS) of the combined group was lower than that of the stand-alone group during the whole follow-up period (all p ≤ 0.001). Multiple linear regression suggested that lower BMD was the risk factor for main CS, and PSRF could significantly reduce the BMD threshold for severe CS (−4.77 vs −1.38). Conclusions OLIF combined with PSRF can effectively avoid foraminal height loss and prevent severe CS, which may be more suitable for patients with osteoporosis or osteopenia and improve clinical outcomes.https://doi.org/10.1186/s13018-021-02570-8
spellingShingle Kaiwen Cai
Kefeng Luo
Jinjin Zhu
Kai Zhang
Shengkai Yu
Yi Ye
Guoqiang Jiang
Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
Journal of Orthopaedic Surgery and Research
title Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
title_full Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
title_fullStr Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
title_full_unstemmed Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
title_short Effect of pedicle-screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis: a retrospective cohort study
title_sort effect of pedicle screw rod fixation on oblique lumbar interbody fusion in patients with osteoporosis a retrospective cohort study
url https://doi.org/10.1186/s13018-021-02570-8
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