Lixian Tan, Xiaokang Du, Runmin Tang, Limin Rong, Liangming Zhang
{"title":"腰椎椎体间融合术后，术前相邻面关节骨关节炎与相邻节段退变和腰痛的发生率有关。","authors":"Lixian Tan, Xiaokang Du, Runmin Tang, Limin Rong, Liangming Zhang","doi":"10.31616/asj.2023.0131","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To analyze the association between preoperative adjacent facet joint osteoarthritis (FJOA) and outcomes of lumbar interbody fusion (LIF).</p><p><strong>Overview of literature: </strong>Whether preoperative adjacent FJOA is associated with the incidence of radiological adjacent segment degeneration (RASD) and low back pain (LBP) relief after lumbar fusion remains unknown.</p><p><strong>Methods: </strong>The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD.</p><p><strong>Results: </strong>In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498-0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020-1.939).</p><p><strong>Conclusions: </strong>The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. Patients with preoperative FJOA were more likely to have RASD following lumbar fusion surgery.</p>","PeriodicalId":8555,"journal":{"name":"Asian Spine Journal","volume":" ","pages":"21-31"},"PeriodicalIF":2.3000,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10910148/pdf/","citationCount":"0","resultStr":"{\"title\":\"Preoperative Adjacent Facet Joint Osteoarthritis Is Associated with the Incidence of Adjacent Segment Degeneration and Low Back Pain after Lumbar Interbody Fusion.\",\"authors\":\"Lixian Tan, Xiaokang Du, Runmin Tang, Limin Rong, Liangming Zhang\",\"doi\":\"10.31616/asj.2023.0131\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Purpose: </strong>To analyze the association between preoperative adjacent facet joint osteoarthritis (FJOA) and outcomes of lumbar interbody fusion (LIF).</p><p><strong>Overview of literature: </strong>Whether preoperative adjacent FJOA is associated with the incidence of radiological adjacent segment degeneration (RASD) and low back pain (LBP) relief after lumbar fusion remains unknown.</p><p><strong>Methods: </strong>The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD.</p><p><strong>Results: </strong>In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498-0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020-1.939).</p><p><strong>Conclusions: </strong>The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. 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引用次数: 0
摘要
研究设计目的：分析术前邻近面关节骨关节炎（FJOA）与腰椎椎间融合术（LIF）结果之间的关联：术前邻近面关节骨关节炎是否与腰椎融合术后放射学邻近节段退变（RASD）的发生率和腰背痛（LBP）缓解有关，目前仍是未知数：研究纳入了接受腰椎间盘突出症融合术的患者。方法：研究纳入了接受腰椎融合术的患者，收集并评估了人口统计学特征、放射学和手术数据。根据术前邻近面关节 Pathria 分级将患者分为对照组和 FJOA 组。对术前和最后一次随访的枸杞多糖视觉模拟量表（VAS）评分、腿痛（LP）VAS、Oswestry残疾指数（ODI）和RASD进行评估和比较。计算并比较两组患者的 VAS 和 ODI 改善率。采用 Logistic 回归分析枸杞痛缓解和 RASD 发生率的风险因素：共纳入197名患者（对照组86名；FJOA组111名），中位随访时间为46个月。两组患者术后的 VAS 和 ODI 均有明显改善。在最后一次随访中，FJOA 组的 VAS 和 VAS 改善率均高于对照组（P结论：术前邻近节段的 FJOA 与 LIF 术后的 LBP 明显相关。术前存在 FJOA 的患者在腰椎融合手术后更有可能出现 RASD。
Preoperative Adjacent Facet Joint Osteoarthritis Is Associated with the Incidence of Adjacent Segment Degeneration and Low Back Pain after Lumbar Interbody Fusion.
Study design: A retrospective cohort study.
Purpose: To analyze the association between preoperative adjacent facet joint osteoarthritis (FJOA) and outcomes of lumbar interbody fusion (LIF).
Overview of literature: Whether preoperative adjacent FJOA is associated with the incidence of radiological adjacent segment degeneration (RASD) and low back pain (LBP) relief after lumbar fusion remains unknown.
Methods: The study included patients who underwent LIF. The demographic characteristics and radiographic and surgical data were collected and evaluated. The included patients were divided into control group and FJOA group based on the preoperative adjacent facet joint Pathria grade. Preoperative and last follow-up LBP Visual Analog Scale (VAS) score, leg pain (LP) VAS, Oswestry Disability Index (ODI) and RASD were evaluated and compared. The improvement rates in VAS and ODI were calculated and compared between the two groups. Logistic regression was used to analyze the risk factors of LBP relief and incidence of RASD.
Results: In total, 197 patients (control group, 86; FJOA group, 111) were included, and the median follow-up was 46 months. The VAS and ODI in both groups significantly improved after surgery. At the last follow-up, the FJOA group had higher VAS and lower VAS improvement rates of LBP than the control group (p<0.05). However, no significant difference in the LP VAS and ODI was found between the two groups. The incidence of RASD in the FJOA group was significantly higher than that in the control group (48.6% vs. 30.2%, p=0.034). Multivariate logistic regression analysis showed that preoperative adjacent FJOA was significantly associated with LBP relief (odds ratio [OR], 0.691; 95% confidence interval [CI], 0.498-0.958) and the postoperative incidence of RASD (OR, 1.406; 95% CI, 1.020-1.939).
Conclusions: The preoperative FJOA in the adjacent segments was significantly associated with LBP following LIF. Patients with preoperative FJOA were more likely to have RASD following lumbar fusion surgery.
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