Evaluating posterior column osteotomy in single-level transforaminal lumbar interbody fusion: A retrospective study

IF 1.8 Q3 ORTHOPEDICS

Journal of orthopaedics Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI:10.1016/j.jor.2026.02.002

Ved A. Vengsarkar , J. Allen Chi , Kate S. Woods , Hanzhi Yang , Yi Zhang , Jestin Williams , Li Jin , Xudong Li

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引用次数: 0

Abstract

Study design

Retrospective cohort study.

ObjectivesTo evaluate the impact of combining posterior column osteotomy (PCO) with single-level transforaminal lumbar interbody fusion (TLIF) on postoperative complications and long-term outcomes.

Methods

Patients undergoing single-level TLIF (CPT-22633) from 2010 to 2019 were identified. Exclusion criteria included malignancy, trauma, infection, or age <18. After matching for demographics and comorbidities, 3221 patients undergoing TLIF with PCO (CPT-22214) were compared to 16,021 patients undergoing TLIF alone, with at least two years of follow up. Multivariable logistic regression was used to assess 90-day medical and surgical complications, two-year pseudarthrosis and hardware failure, and five-year reoperation rates.

Results

Patients undergoing TLIF with PCO had significantly higher rates of 90-day medical complications, including atelectasis (1.9% vs. 1.3%, OR 1.51, p = 0.004), respiratory failure (1.6% vs. 0.7%, OR 2.32, p < 0.001), and pulmonary embolism (0.6% vs. 0.3%, OR 1.83, p = 0.028). Surgical complications were also more frequent, including transfusion (0.8% vs. 0.4%, OR 2.12, p = 0.001) and postoperative radiculopathy (3.4% vs. 2.5%, OR 1.38, p = 0.002). The TLIF-PCO group had a higher rate of pseudarthrosis at two years (3.8% vs. 3.1%, OR 1.25, p = 0.029) and reoperations within five years (13.3% vs. 11.4%, p < 0.001).

Conclusions

The addition of PCO to TLIF is associated with increased medical and surgical complications, as well as a higher rate of pseudarthrosis and reoperation. Future research should focus on radiographic and patient-reported outcomes to refine surgical strategies and optimize long-term results.

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评价单节段椎间孔腰椎椎间融合术中的后柱截骨术：一项回顾性研究

研究设计回顾性队列研究。目的探讨后柱截骨术（PCO）联合单节段经椎间孔腰椎椎体间融合术（TLIF）对术后并发症及远期预后的影响。方法选取2010 - 2019年接受单期TLIF （CPT-22633）治疗的患者。排除标准包括恶性肿瘤、外伤、感染或年龄18岁。在人口统计学和合并症匹配后，3221例接受TLIF联合PCO （CPT-22214）的患者与16021例单独接受TLIF的患者进行了比较，随访时间至少为2年。采用多变量logistic回归评估90天内的内科和外科并发症、2年假关节和硬体失效以及5年的再手术率。结果TLIF合并PCO患者的90天并发症发生率显著高于TLIF患者，包括肺不张（1.9% vs. 1.3%, OR 1.51, p = 0.004）、呼吸衰竭（1.6% vs. 0.7%, OR 2.32, p < 0.001）和肺栓塞（0.6% vs. 0.3%, OR 1.83, p = 0.028）。手术并发症也更频繁，包括输血（0.8%对0.4%,OR 2.12, p = 0.001）和术后神经根病（3.4%对2.5%,OR 1.38, p = 0.002）。tlifl - pco组两年内假关节发生率（3.8% vs. 3.1%, OR 1.25, p = 0.029）和五年内再手术率（13.3% vs. 11.4%, p < 0.001）较高。结论在TLIF中加入PCO会增加内科和外科并发症，以及假关节和再手术的发生率。未来的研究应侧重于放射学和患者报告的结果，以完善手术策略和优化长期结果。

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 orthopaedics ORTHOPEDICS-

CiteScore

3.50

自引率

6.70%

发文量

202

审稿时长

56 days

期刊介绍： Journal of Orthopaedics aims to be a leading journal in orthopaedics and contribute towards the improvement of quality of orthopedic health care. The journal publishes original research work and review articles related to different aspects of orthopaedics including Arthroplasty, Arthroscopy, Sports Medicine, Trauma, Spine and Spinal deformities, Pediatric orthopaedics, limb reconstruction procedures, hand surgery, and orthopaedic oncology. It also publishes articles on continuing education, health-related information, case reports and letters to the editor. It is requested to note that the journal has an international readership and all submissions should be aimed at specifying something about the setting in which the work was conducted. Authors must also provide any specific reasons for the research and also provide an elaborate description of the results.