Abstract
BackgroundTo analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery.MethodsFrom January 2019 to January 2021, 1794 patients with lumbar degenerative disease, such as lumbar disc herniation, lumbar spinal stenosis and lumbar spondylolisthesis, were treated at our hospital. In all, 1221 cases were included. General data (sex, age, BMI), bone mineral density, proximal facet joint angle, degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment in the two groups were recorded. After the operation, vertebral CT of the corresponding surgical segments was performed for three-dimensional reconstruction and evaluation of whether the vertebral arch root screw interfered with the proximal facet joint. The included cases were divided into an invasion group and a noninvasion group. Univariate analysis was used to screen the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery, and the selected risk factors were included in the logistic model for multivariate analysis.ResultsThe single-factor analysis showed a significant difference in age, BMI, proximal facet joint angle, degenerative lumbar spondylolisthesis, and fixed segment (P < 0.1). Multifactor analysis of the logistic model showed a significant difference for age ≥ 50 years (P < 0.001, OR = 2.291), BMI > 28 kg/m2 (P < 0.001, OR = 2.548), degenerative lumbar spondylolisthesis (P < 0.001, OR = 2.187), gorge cleft lumbar relaxation (P < 0.001, OR = 2.410), proximal facet joint angle (35 ~ 45°: P < 0.001, OR = 3.151; > 45°: P < 0.001, OR = 3.578), and fixed segment (lower lumbar spine: P < 0.001, OR = 2.912).ConclusionAge (≥ 50 years old), BMI (> 28 kg/m2), proximal facet joint angle (35 ~ 45°, > 45°), degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment (lower lumbar spine) are independent risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. Compared with degenerative lumbar spondylolisthesis, facet joint intrusion is more likely in isthmic lumbar spondylolisthesis.
Highlights
To analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery
This study considered that age (≥ 50 years old), BMI (> 28 kg/m2), proximal facet joint angle (35 ~ 45°, > 45°), degenerative lumbar spondylolisthesis, isthmic lumbar spondylolisthesis and fixed segment were risk factors affecting pedicle screw invasion of the proximal facet joint
Effect of lumbar spondylolisthesis on pedicle screw invasion of the proximal facet joint The results showed that degenerative lumbar spondylolisthesis (P < 0.001, OR = 2.187) and isthmic lumbar spondylolisthesis (P < 0.001, OR = 2.410) increased the risk of postoperative pedicle screw invasion of the proximal facet joint
Summary
To analyze the risk factors for pedicle screw invasion of the proximal facet joint after lumbar surgery. In clinical practice, the pedicle screw system is often used for the internal fixation of corresponding vertebral bodies in the treatment of various diseases, such as spinal instability, vertebral fracture, lumbar. Wang et al BMC Musculoskeletal Disorders (2022) 23:39 literature [5, 7], the implantation of pedicle screws after lumbar surgery is an important risk factor for proximal facet joint invasion, but there have been few reports on the risk factors related to pedicle screw implantation. This study used multivariate analysis to explore the risk factors for proximal facet joint invasion related to pedicle screw implantation
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