Huang Zheng, Li Xialin, Yi Weihong, Gong Junfeng, Zhou Yue, Tang Yu
Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China.
Department of Orthopedics, Xinqiao Hospital affiliated to Army Military Medical University, Chongqing, China.
Acta Orthop Traumatol Turc. 2024 Oct 25;58(6):353-357. doi: 10.5152/j.aott.2024.23142.
Lumbar spinal fusion is a common procedure for treating spinal degenerative diseases. Percutaneous endoscopic lumbar interbody fusion (PELIF) is a minimally invasive technique that has gained popularity. However, the factors influencing fusion success rates after PELIF have not been well-studied.
This single-center retrospective study reviewed the medical records of 96 patients who underwent single-level PELIF for degenerative pathologies between 2018 and 2020. Fusion was evaluated using thin-slice computed tomography scans at 12 months by 2 independent radiologists and defined as no detectable lucency between bone and graft. Patients were categorized into fusion and non-fusion groups. Data on age, operative time, blood loss, drainage, hospital stay, surgical level, osteoporosis, endplateitis, body mass index, lumbar curvature, and bone morphogenetic protein (BMP) use were collected. Univariate tests (chi-square, Student’s t-test, and analysis of variance) were employed to compare factors between groups. Significant factors were included in a multivariate logistic regression model with fusion as the dependent variable.
The overall fusion success rate was 85.6% (86 fusion and 10 non-fusion). Univariate analysis revealed significant di!erences in age, osteoporosis, hypertension, diabetes, endplateitis, and BMP use between groups. Multivariate analysis identified osteoporosis (odds ratio (OR)=5.44, 95% CI, P < .05) and end-plate osteochondritis (OR=10.449, 95% CI, P < .05) as independent risk factors for non-fusion.
The use of BMP and endplateitis are significant factors that a!ect bone fusion outcomes after the PELIF procedure. These factors should be taken into account in order to improve postoperative bone fusion.
Level IV, Therapeutic Study
腰椎融合术是治疗脊柱退行性疾病的常见手术。经皮内镜下腰椎椎间融合术（PELIF）是一种微创技术，已逐渐普及。然而，影响PELIF术后融合成功率的因素尚未得到充分研究。
本单中心回顾性研究回顾了2018年至2020年间96例因退行性病变接受单节段PELIF手术患者的病历。由2名独立放射科医生在12个月时使用薄层计算机断层扫描评估融合情况，定义为骨与移植物之间无明显透亮区。患者被分为融合组和未融合组。收集患者的年龄、手术时间、失血量、引流量、住院时间、手术节段、骨质疏松症、终板炎、体重指数、腰椎曲度和骨形态发生蛋白（BMP）使用情况等数据。采用单因素检验（卡方检验、学生t检验和方差分析）比较两组间的因素。将有显著意义的因素纳入以融合为因变量的多因素逻辑回归模型。
总体融合成功率为85.6%（86例融合，10例未融合）。单因素分析显示，两组间在年龄、骨质疏松症、高血压、糖尿病、终板炎和BMP使用方面存在显著差异。多因素分析确定骨质疏松症（比值比（OR）=5.44，95%可信区间，P<.05）和终板骨软骨炎（OR=10.449，95%可信区间，P<.05）是未融合的独立危险因素。
BMP的使用和终板炎是影响PELIF手术后骨融合结果的重要因素。为提高术后骨融合效果，应考虑这些因素。
IV级，治疗性研究
