Risk factors and prevention strategy for patient dissatisfaction after transforaminal lumbar interbody fusion: a single-center retrospective study.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-02-11 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1545591

Lixin Yang, Zhao Guo, Yuhao Qiao, Jichao Guo, Jiaqi Li, Wei Wang

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引用次数: 0

Abstract

Background: For patients who received transforaminal lumbar interbody fusion (TLIF) treatment for lumbar disc herniation, most of them can achieve good results, but there were still some patients who were not satisfied with the surgical results. The purpose of this study is to explore the factors that contribute to patient dissatisfaction after TLIF.

Methods: From March 2018-December 2021, patients with lumbar disc herniation who received TLIF treatment were included in this study. Clinical data from preoperative and postoperative 2-year follow-up were analyzed. Associations between clinical variables and function of postoperative were examined in univariate and multivariate analysis.

Result: Of all the 625 patients, including 296 (47.4%) male patients and 329 (52.6%) female patients. According to patient satisfaction index (PSI), patients were divided into two groups, 529 patients in satisfied group showing 1 or 2 stage in PSI and 96 patients in dissatisfied group showing 3 or 4 stage in PSI. Univariate analysis showed that body mass index (BMI), preoperative pain time, postoperative visual analog scale (VAS)-back, intraoperative bleeding volume, postoperative rehabilitation training, feel depression and symptom recurrence were related with patient's level of satisfaction 2 years after discectomy. When incorporated into a multivariate logistic regression analysis, it was found that BMI, preoperative pain duration, postoperative rehabilitation training, feel depression and symptom recurrence were individually correlated with patient dissatisfaction 2 years after discectomy.

Conclusion: This study indicates that the factors that leading to postoperative dissatisfaction of patients include obesity, preoperative pain duration lasting no less than 6 months, feel depression and symptom recurrence. While postoperative rehabilitation training for three months is a protective factor.

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经椎间孔腰椎椎间融合术后患者不满意的危险因素及预防策略：一项单中心回顾性研究。

背景：经椎间孔腰椎椎体间融合术（TLIF）治疗腰椎间盘突出症，多数患者均能取得较好的效果，但仍有部分患者对手术效果不满意。本研究的目的是探讨导致TLIF术后患者不满意的因素。方法：2018年3月至2021年12月，接受TLIF治疗的腰椎间盘突出症患者纳入本研究。分析术前和术后2年随访的临床资料。通过单因素和多因素分析检验临床变量与术后功能之间的关系。结果：625例患者中，男性296例（47.4%），女性329例（52.6%）。根据患者满意度指数（PSI）将患者分为两组，满意组529例PSI为1、2期，不满意组96例PSI为3、4期。单因素分析显示，体重指数（BMI）、术前疼痛时间、术后视觉模拟量表(VAS)-背部、术中出血量、术后康复训练、感觉抑郁、症状复发与患者术后2年满意度相关。纳入多因素logistic回归分析后发现，BMI、术前疼痛持续时间、术后康复训练、感觉抑郁、症状复发与椎间盘切除术后2年患者的不满意程度分别相关。结论：本研究提示导致患者术后不满意的因素包括肥胖、术前疼痛持续时间不少于6个月、感觉抑郁、症状复发。而术后三个月的康复训练是一个保护因素。

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

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.