Abstract
BackgroundThe purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF).MethodsA total of 69 patients with lumbar degenerative disease, who underwent MIS-TLIF were retrospectively reviewed. Postoperative computed tomography images were used to assess the facet joint violation. The correlation of facet joint violations with gender, age, body mass index (BMI), the adjacent superior vertebral level, fusion segment numbers, position of screw insertion, straight leg-raising test (SLRT) results, clinical diseases and renal dysfunction were analyzed by Chi-square tests and binary logistic regression analysis.ResultsThe incidence of adjacent superior facet joint violations was 25.4 %. Chi-square test showed the patients with age <60 and high BMI (≥30 kg/m2) were more prone to have facet joint violations (P = 0.007; P = 0.006). The single segment fusion presented more facet joint violations than the double segments fusion (P = 0.048). The vertebral pedicle screw implant location at L5 showed more facet joint violations compared with that at L3 and L4 (P = 0.035). No correlation was found between gender, screw implant position, SLRT results, clinical diseases and renal dysfunction and facet joint violations. Logistic regression analysis revealed that age <60 years (OR: 2.902; 95 % CI 1.227–6.864; P = 0.015) and BMI ≥30 kg/m2 (OR: 2.825; 95 % CI 1.191–6.700; P = 0.018 < 0.05) were significantly associated with facet joint violation.ConclusionThese results found a high incidence of adjacent superior vertebral facet joint violation in the MIS-TLIF. Age <60 and BMI ≥30 kg/m2 might be risk factors of facet joint violation.Evidence level: Level 4.
Highlights
The purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-Transforaminal lumbar interbody fusion (TLIF))
It has been established that the adjacent vertebral facet joint violation is a potential risk factor for accelerating the adjacent segment degeneration [12, 13]
In this study, we retrospectively reviewed the clinical data of 69 patients who underwent MIS-TLIF, and assessed relevant risk factors of facet joint violation caused by adjacent superior vertebral pedicle screw, including gender, age, body mass index (BMI), the location of adjacent upper vertebral, fusion segment numbers, screw implant location and others
Summary
The purpose was to explore possible risk factors of facet joint violation induced by adjacent superior vertebral pedicle screw during the minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF). Increasing concern has been given on the postoperative complications. Zeng et al Eur J Med Res (2015) 20:80 long-term complication is adjacent segment degeneration. There is evidence that sagittal orientation or tropism at the adjacent segment might be potential risk factors of adjacent segment degeneration [6]. Biochemical analysis reveals that the lumbar fusion causes increased facet loading that might lead to adjacent segment degeneration [10, 11]. It has been established that the adjacent vertebral facet joint violation is a potential risk factor for accelerating the adjacent segment degeneration [12, 13]. One main contributor to the facet joint violations is placement of the pedicle screws [13, 14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
