Kraiwattanapong Chaiwat, Chandrsawang Issara, Keorochana Gun, Rajinda Panupol, Chanplakorn Pongsthorn, Leelapattana Pittavat, Udomsubpayakul Umaporn, Lertudomphonwanit Thamrong
Department of Orthopaedics, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Bangkok, 10400, Thailand.
Department of Orthopaedics, Sunpasitthiprasong Hospital, Ubonratchathani, Thailand.
BMC Musculoskelet Disord. 2025 Feb 1;26(1):95. doi: 10.1186/s12891-024-08184-5.
Lumbar posterolateral fusion (PLF) with Pedicle Screw-Plate (PSP) fixation without interbody fusion found spontaneous anterior fusion (SAF). No study has reported the SAF of lumbar spine in patients who underwent PLF. This study reports the rate of SAF of lumbar spine after PLF with PSP system compared with the rate of SAF after PLF with pedicle screw-rod (PSR) system.
Retrospective reviews of charts and radiographs were performed in 111 patients who underwent PLF with PSP system and PSR system for treatment of degenerative lumbar spine. Demographic data, diagnosis, Meyerding grading, level of fusion, Pfirrmann grading, disc height, pedicle screw depth, follow-up time and SAF were compared between PSP and PSR groups.
Fifty-five patients in the PSP group and 56 patients in the PSR group were included with similar baseline characteristics. There were more degenerative spondylolisthesis patients in the PSP group compared with patients in the PSR group. However, there was no significant difference of Pfirrmann grading in both groups. Fifteen patients (27.3%) in the PSP group developed SAF while no patient in the PSR group had SAF. When patients in the PSP group were analyzed, the mean follow-up time in patients with SAF was significantly longer than the no SAF group.
This study has reported SAF of lumbar spine in patients who underwent PLF with the PSP system. The SAF increasingly occurred with longer follow-up time. In this study, no SAF was found in patients who underwent PLF with the PSR system.
采用椎弓根螺钉-钢板（PSP）固定且无椎间融合的腰椎后外侧融合术（PLF）出现了自发前路融合（SAF）。尚无研究报道接受PLF的患者腰椎的SAF情况。本研究报告了采用PSP系统行PLF术后腰椎SAF的发生率，并与采用椎弓根螺钉-棒（PSR）系统行PLF术后的SAF发生率进行比较。
对111例行PSP系统和PSR系统PLF治疗退变性腰椎疾病的患者的病历和X线片进行回顾性分析。比较PSP组和PSR组的人口统计学数据、诊断、迈耶丁分级、融合节段、菲尔曼分级、椎间盘高度、椎弓根螺钉深度、随访时间和SAF情况。
PSP组纳入55例患者，PSR组纳入56例患者，两组基线特征相似。与PSR组患者相比，PSP组退变性椎体滑脱患者更多。然而，两组的菲尔曼分级无显著差异。PSP组有15例患者（27.3%）发生SAF，而PSR组无患者发生SAF。对PSP组患者进行分析时，发生SAF的患者平均随访时间显著长于未发生SAF的组。
本研究报告了采用PSP系统行PLF的患者腰椎的SAF情况。SAF随着随访时间的延长而越来越多地出现。在本研究中，采用PSR系统行PLF的患者未发现SAF。
