Graft subsidence as a predictor of revision surgery following stand-alone lateral lumbar interbody fusion

• DOI: 10.3171/2017.5.spine16427
• Publication Date: 2017-11-10T15:02:30Z
• Authors: Zachary J. Tempel; Michael M. McDowell; David M. Panczyko...; Gurpreet S. Gandhoke; D. Kojo Hamilton; David O. Okonkwo; Adam S. Kanter
• Keywords: Male; Reoperation; 2. Zero hunger; Lumbar Vertebrae; Middle Aged; Internal Fixators; 3. Good health; 03 medical and health sciences; Postoperative Complications; Spinal Fusion; 0302 clinical medicine; Humans; Female; Spinal Diseases; Aged; Retrospective Studies

OBJECTIVE Lateral lumbar interbody fusion (LLIF) is a less invasive surgical option commonly used for variety of spinal conditions, including in high-risk patient populations. LLIF often performed as stand-alone procedure, and may be complicated by graft subsidence, the clinical ramifications which remain unclear. The aim this study was to characterize further sequelae subsidence following LLIF. METHODS A retrospective review prospectively collected data conducted on consecutive patients who underwent between July 2008 June 2015; 297 (623 levels) met inclusion criteria. Imaging studies were examined grade according Marchi criteria, compared those required revision surgery did not. Additional variables recorded included levels fused, DEXA (dual-energy x-ray absorptiometry) T-score, body mass index, routine demographic information. analyzed using Student t-test, chi-square analysis, logistic regression analysis identify potential confounding factors. RESULTS Of patients, 34 (11.4%) had radiographic evidence 18 (6.1%) surgery. median requiring 2.5, with 1 Chi-square revealed significantly higher incidence high-grade low-grade subsidence. Seven (38.9%) suffered vertebral fracture. High-grade significant predictor need (p < 0.05; OR 12, 95% CI 1.29-13.6), whereas age, number fused This relationship remained despite adjustment other (OR 14.4; 1.30-15.9). CONCLUSIONS In series, more than half developed When evaluating LLIF, supplemental instrumentation should considered during index risk