Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis
Objective Nowadays, with the increasing proportion of osteoporosis in patients with lumbar degenerative diseases, doctors are facing the choice of intraoperative internal fixation methods. The purpose of this study was to compare and assess the clinical results of posterior bilateral pedicle screw f...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-12-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.13540 |
| _version_ | 1828091672320278528 |
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| author | Xianzheng Wang Huanan Liu Weijian Wang Yapeng Sun Fei Zhang Lei Guo Jiaqi Li Wei Zhang |
| author_facet | Xianzheng Wang Huanan Liu Weijian Wang Yapeng Sun Fei Zhang Lei Guo Jiaqi Li Wei Zhang |
| author_sort | Xianzheng Wang |
| collection | DOAJ |
| description | Objective Nowadays, with the increasing proportion of osteoporosis in patients with lumbar degenerative diseases, doctors are facing the choice of intraoperative internal fixation methods. The purpose of this study was to compare and assess the clinical results of posterior bilateral pedicle screw fixation and lateral fixation in the extreme lateral interbody fusion (XLIF) in patients with osteopenia or osteoporosis. Methods The retrospective review was performed on 67 degenerative lumbar diseases patients with osteopenia or osteoporosis who underwent XLIF in our hospital from January 2018 to July 2021. Patients in this study were classified into lateral screw (LS) group, lateral self‐locking plate (LP) group, and bilateral pedicle screw (BPS) group. The functional evaluation factors containing Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) of leg pain, and VAS of low back pain, radiological factors such as disc height (DH), lumbar lordotic (LL) angle, segmental lordotic (SL) angle, cage subsidence degree and interbody fusion degree were compared. Results Primary outcomes: no differences were observed with regards to the incidence of complications among LS, LP and BS group (P < 0.05). The JOA and leg pain VAS were significantly improved after operation (P < 0.05) and all groups demonstrated similar improvements in the leg pain VAS and JOA score (P > 0.05). When comparing VAS of leg pain and JOA scores, no differences were identified among LS, LP and BPS groups (P > 0.05). There are four thigh sensory complaint, one hip flexor weakness and one thigh pain occurred and no death was observed. There were significantly better DH, LL angle, SL angle, cage subsidence degree and interbody fusion degree in the BPS group than in LS and LP groups 1 year after surgery (P < 0.05). The DH loss ratio, LL angle loss ratio, SL angle loss ratio in the BPS group was significantly lower than in the LP and LS groups (P < 0.05). The 12‐month SL angle improvement rate in the BPS group was significantly higher than in the LP and LS groups (20.20 ± 14.69, 0.73 ± 4.68, 6.20 ± 12.31, P < 0.05). Secondary outcomes: the BPS patients had significantly worse intraoperative blood loss and operation time than LS and LP patients (P < 0.05). Conclusion In lumbar diseases patients with osteopenia or osteoporosis, the bilateral pedicle screw fixation has better orthopedic effect than lateral internal fixation, and can better maintain the stability of the spine in the long‐term follow‐up, which is a better choice in XLIF surgery. |
| first_indexed | 2024-04-11T06:16:45Z |
| format | Article |
| id | doaj.art-c49463bccdbf4fc78a3b5efc781ea982 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-04-11T06:16:45Z |
| publishDate | 2022-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-c49463bccdbf4fc78a3b5efc781ea9822022-12-22T04:41:02ZengWileyOrthopaedic Surgery1757-78531757-78612022-12-0114123283329210.1111/os.13540Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or OsteoporosisXianzheng Wang0Huanan Liu1Weijian Wang2Yapeng Sun3Fei Zhang4Lei Guo5Jiaqi Li6Wei Zhang7Department of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaDepartment of Spinal Surgery The Third Hospital of Hebei Medical University Shijiazhuang ChinaObjective Nowadays, with the increasing proportion of osteoporosis in patients with lumbar degenerative diseases, doctors are facing the choice of intraoperative internal fixation methods. The purpose of this study was to compare and assess the clinical results of posterior bilateral pedicle screw fixation and lateral fixation in the extreme lateral interbody fusion (XLIF) in patients with osteopenia or osteoporosis. Methods The retrospective review was performed on 67 degenerative lumbar diseases patients with osteopenia or osteoporosis who underwent XLIF in our hospital from January 2018 to July 2021. Patients in this study were classified into lateral screw (LS) group, lateral self‐locking plate (LP) group, and bilateral pedicle screw (BPS) group. The functional evaluation factors containing Japanese Orthopaedic Association (JOA) score, visual analogue scale (VAS) of leg pain, and VAS of low back pain, radiological factors such as disc height (DH), lumbar lordotic (LL) angle, segmental lordotic (SL) angle, cage subsidence degree and interbody fusion degree were compared. Results Primary outcomes: no differences were observed with regards to the incidence of complications among LS, LP and BS group (P < 0.05). The JOA and leg pain VAS were significantly improved after operation (P < 0.05) and all groups demonstrated similar improvements in the leg pain VAS and JOA score (P > 0.05). When comparing VAS of leg pain and JOA scores, no differences were identified among LS, LP and BPS groups (P > 0.05). There are four thigh sensory complaint, one hip flexor weakness and one thigh pain occurred and no death was observed. There were significantly better DH, LL angle, SL angle, cage subsidence degree and interbody fusion degree in the BPS group than in LS and LP groups 1 year after surgery (P < 0.05). The DH loss ratio, LL angle loss ratio, SL angle loss ratio in the BPS group was significantly lower than in the LP and LS groups (P < 0.05). The 12‐month SL angle improvement rate in the BPS group was significantly higher than in the LP and LS groups (20.20 ± 14.69, 0.73 ± 4.68, 6.20 ± 12.31, P < 0.05). Secondary outcomes: the BPS patients had significantly worse intraoperative blood loss and operation time than LS and LP patients (P < 0.05). Conclusion In lumbar diseases patients with osteopenia or osteoporosis, the bilateral pedicle screw fixation has better orthopedic effect than lateral internal fixation, and can better maintain the stability of the spine in the long‐term follow‐up, which is a better choice in XLIF surgery.https://doi.org/10.1111/os.13540Cage subsidenceExtreme lateral interbody fusionFusionInternal fixation |
| spellingShingle | Xianzheng Wang Huanan Liu Weijian Wang Yapeng Sun Fei Zhang Lei Guo Jiaqi Li Wei Zhang Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis Orthopaedic Surgery Cage subsidence Extreme lateral interbody fusion Fusion Internal fixation |
| title | Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis |
| title_full | Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis |
| title_fullStr | Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis |
| title_full_unstemmed | Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis |
| title_short | Comparison of Posterior Pedicle Screw Fixation and Lateral Fixation in the Extreme Lateral Interbody Fusion in Lumbar Degenerative Disease Patients with Osteopenia or Osteoporosis |
| title_sort | comparison of posterior pedicle screw fixation and lateral fixation in the extreme lateral interbody fusion in lumbar degenerative disease patients with osteopenia or osteoporosis |
| topic | Cage subsidence Extreme lateral interbody fusion Fusion Internal fixation |
| url | https://doi.org/10.1111/os.13540 |
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