Abduljabbar Fahad H, Makhdom Asim M, Rajeh Mona, Tales Alisson R, Mathew Jacob, Ouellet Jean, Weber Michael, Jarzem Peter
McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, Canada.
Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia.
Global Spine J. 2017 Dec;7(8):780-786. doi: 10.1177/2192568217696693. Epub 2017 Apr 7.
A retrospective cohort study.
The aim of this study is to assess the association of demographic and perioperative factors with clinical outcomes of lumbar interbody fusion with a porous nitinol (TiNi) implant for degenerative disc disease.
Forty-one patients with degenerative lumbar disease were prospectively followed for a mean of 4.8 years. All patients were instrumented with porous TiNi interbody fusion devices. The Oswestry Disability Index (ODI) and return to work were used to assess clinical outcomes. Factors including age, body mass index, smoking status, insurance status, number of comorbidities, duration of surgery, estimated blood loss, number of levels fused, time since surgery, and preoperative ODI score were assessed. A multiple linear regression analysis was performed to look for demographic and perioperative factors associated with clinical outcome.
All patients except one (98%) showed complete fusion on radiography at 1 year. Estimated blood loss and duration of surgery were significantly associated with higher postoperative ODI scores ( = .002 and = .019, respectively). Smoking status, salary insurance status, age, body mass index, number of comorbidities, number of levels fused, time since surgery, and preoperative ODI score were not significantly associated with outcome.
Porous nitinol permitted fusion rates similar to those reported in the literature for alternative fusion cages. Poor functional outcome of patients was strongly associated with intraoperative blood loss and duration of surgery. We believe that estimated blood loss should be carefully evaluated in studies of postoperative outcome, as it may affect midterm outcomes.
Level 3.
一项回顾性队列研究。
本研究旨在评估人口统计学和围手术期因素与使用多孔镍钛合金（TiNi）植入物治疗退行性椎间盘疾病的腰椎椎间融合术临床结局之间的关联。
对41例退行性腰椎疾病患者进行前瞻性随访，平均随访4.8年。所有患者均使用多孔TiNi椎间融合装置。采用奥斯威斯功能障碍指数（ODI）和恢复工作情况来评估临床结局。评估的因素包括年龄、体重指数、吸烟状况、保险状况、合并症数量、手术时长、估计失血量、融合节段数、术后时间以及术前ODI评分。进行多元线性回归分析以寻找与临床结局相关的人口统计学和围手术期因素。
除1例患者（98%）外，所有患者在术后1年的影像学检查中均显示完全融合。估计失血量和手术时长与术后较高的ODI评分显著相关（分别为P = .002和P = .019）。吸烟状况、薪资保险状况、年龄、体重指数、合并症数量、融合节段数、术后时间以及术前ODI评分与结局无显著关联。
多孔镍钛合金实现的融合率与文献报道的其他融合器相似。患者功能结局不佳与术中失血量和手术时长密切相关。我们认为，在术后结局研究中应仔细评估估计失血量，因为它可能影响中期结局。
3级。
