Comparison of Intraoperative Endplate Injury between Mini-Open Lateral Lumbar Interbody Fusion (LLIF) and Transforaminal Lumbar Interbody Fusion (TLIF) and Analysis of Risk Factors: A Retrospective Study.

IF 2.1 4区医学 Q2 SURGERY

Journal of Investigative Surgery Pub Date : 2023-12-01 Epub Date: 2023-11-27 DOI:10.1080/08941939.2023.2285787

Xiaowei Jing, Zhiyuan Gong, Ning Zhang, Zhengkuan Xu, Xiaowen Qiu, Fangcai Li, Wei Liu, Qingfeng Hu, Qixin Chen

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引用次数: 0

Abstract

Objective: The study aimed to compare the incidence of intraoperative endplate injury in patients who underwent Transforaminal interbody fusion (TLIF) and mini-open lumbar interbody fusion (LLIF) surgery. The independent risk factors related to endplate injury in LLIF procedure were analyzed.

Methods: A total of 199 patients who underwent LLIF (n = 106) or TLIF (n = 93) surgery from June 2019 to September 2021 were reviewed. The endplate injury was assessed by postoperative sagittal CT scan. A binary logistic analysis model were used to identify independent risk factors related to LLIF endplate injury based on univariate analysis.

Results: There was an obvious difference in the occurrence of intraoperative endplate injury between LLIF (42/106, 39.6%) and TLIF group (26/93, 28%), although it did not reach the significant level. L1 CT value (OR = 0.985, 95% CI = 0.972-0.998), cage position (OR = 3.881, 95% CI = 1.398-10.771) and height variance (OR = 1.263, 95% CI = 1.013-1.575) were independent risk factors for endplate injury in LLIF procedure. According to the cage settlement patterns, there 5 types of A to E. The severity of the facet joint degeneration was positively related to the occurrence of endplate injury.

Conclusions: The incidence of intraoperative endplate injury is higher in LLIF than in TLIF procedures. Low bone quantity, cage posterior position and larger height variance are risk factors to induce endplate injury in LLIF surgery. The facet joint degeneration may be related to severe endplate injuries and even fractures.

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微创外侧腰椎椎间融合术(LLIF)与椎间孔腰椎椎间融合术(TLIF)术中终板损伤的比较及危险因素分析:一项回顾性研究

目的:本研究旨在比较经椎间孔椎间融合术(TLIF)和小开放式腰椎椎间融合术(LLIF)患者术中终板损伤的发生率。分析LLIF手术中导致终板损伤的独立危险因素。方法:回顾2019年6月至2021年9月共199例接受LLIF (n = 106)或TLIF (n = 93)手术的患者。术后矢状CT扫描评估终板损伤。在单因素分析的基础上，采用二元logistic分析模型识别与LLIF终板损伤相关的独立危险因素。结果:LLIF组术中终板损伤发生率(42/106,39.6%)与TLIF组术中终板损伤发生率(26/93,28%)差异有统计学意义，但未达到显著水平。L1 CT值(OR = 0.985, 95% CI = 0.972 ~ 0.998)、笼位(OR = 3.881, 95% CI = 1.398 ~ 10.771)和高度方差(OR = 1.263, 95% CI = 1.013 ~ 1.575)是LLIF手术终板损伤的独立危险因素。根据笼沉降模式分为A ~ e 5种，关节突关节退变的严重程度与终板损伤的发生呈正相关。结论:LLIF术中终板损伤发生率高于TLIF。低骨量、cage后位、高度方差较大是LLIF手术中诱发终板损伤的危险因素。小关节退变可能与严重的终板损伤甚至骨折有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Investigative Surgery 医学-外科

CiteScore

4.20

自引率

0.00%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.